Archives of Gynecology and Obstetrics

, Volume 298, Issue 4, pp 813–820 | Cite as

Risk of endometrial cancer in asymptomatic postmenopausal patients with thickened endometrium: data from the FAME-Endo study: an observational register study

  • Lukas HeflerEmail author
  • Judith Lafleur
  • Sonja Kickmaier
  • Heinz Leipold
  • Carmen Siebenhofer
  • Barbara Tringler
  • Christian Schauer
  • Alexandra Ciresa-König
  • Alexander Reinthaller
Gynecologic Oncology



To evaluate the risk for endometrial cancer (EC) in a large series of asymptomatic patients with thickened endometrium at ultrasound examination based on previously published data of a theoretical cohort.


In a prospective register study, a total of 1024 women with thickened endometrium in ultrasound examination undergoing histological diagnosis by dilation, hysteroscopy and curettage were evaluated. 124 patients were excluded due to current medication with tamoxifen and/or presence of HNPCC leaving 900 patients for further analysis.


Mean [standard deviation (SD)] age of patients was 65.6 (8.6) years. Mean (SD) endometrial thickness was 11.9 (5.8) mm. 32 and 6 cases of EC and complex endometrial hyperplasia with atypia were found, respectively. In the univariate analysis, a statistically significant association between endometrial thickness, current use of antihypertensive medication, number of deliveries, and the presence of endometrial fluid in preoperative vaginal ultrasound (p < 0.05) with EC was found. A multivariate logistic regression model incorporating these parameters showed a statistically significant independent association of endometrial thickness, number of deliveries, and the presence of endometrial fluid in preoperative vaginal ultrasound (p < 0.05), but not current use of antihypertensive medication, with EC. Using a cut-off of the endometrial thickness of > 11 mm, the risk for “EC alone” and “EC and complex endometrial hyperplasia with atypia combined” was found to be 6.7% and 7.9%, respectively.


Our data compare favorably to a theoretical cohort suggesting a clinically reasonable cut-off of > 11 mm endometrial thickness to discriminate between “normal” and “pathological”. The data regarding “risk for endometrial cancer” can be used for counseling affected women.


Thickened endometrium Endometrial cancer Cut-off Screening Endometrial thickness Endometrial diameter 


Author contributions

LH: Protocol/project development, Data analysis, Manuscript writing/editing. JL: Data collection or management, Protocol/project development, Data analysis, Manuscript writing/editing. SK: Data collection or management. HL: Data collection or management. CS: Data collection or management. BT: Data collection or management. CS: Data collection or management, Manuscript editing. AC-K: Data collection or management. AR: Protocol/project development Data collection or management, Manuscript editing.

Compliance with ethical standards

Ethical approval

Approval for this study was obtained by the respective Institutional Review Boards (EK 484/2009).

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Formal consent

For this type of study formal consent is not required.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Lukas Hefler
    • 1
    • 2
    Email author
  • Judith Lafleur
    • 1
    • 2
  • Sonja Kickmaier
    • 3
  • Heinz Leipold
    • 4
  • Carmen Siebenhofer
    • 5
  • Barbara Tringler
    • 6
  • Christian Schauer
    • 7
  • Alexandra Ciresa-König
    • 8
  • Alexander Reinthaller
    • 3
  1. 1.Department of Obstetrics and GynecologyGynecological Cancer Center, Ordensklinikum LinzLinzAustria
  2. 2.Karl Landsteiner Institute of Gynecolgical Surgery and OncologyLinzAustria
  3. 3.Department of Obstetrics and GynecologyMedical University of ViennaViennaAustria
  4. 4.Department of Obstetrics and GynecologyLandeskrankenhaus KlagenfurtKlagenfurtAustria
  5. 5.Department of Obstetrics and GynecologyLandeskrankenhaus OberpullendorfOberpullendorfAustria
  6. 6.Department of Obstetrics and GynecologyMedical University of SalzburgSalzburgAustria
  7. 7.Department of GynecologyKonventhospital Barmherzige BruederGrazAustria
  8. 8.Department of Obstetrics and GynecologyMedical University of InnsbruckInnsbruckAustria

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