Endometrial Assessment: When is it Necessary?

BACKGROUND: Endometrial cancer is the fourth most common cancer among women and the most common malignant neoplasm of the female genital tract in the USA. The onset is usually after the age of 50 and prognosis depends on the stage of disease at diagnosis. We aimed at determining the prevalence of high-risk endometrial lesions in women of different ages to establish a protocol for the indication of invasive diagnostic procedures. METHODS: A retrospective study was conducted based on the descriptive and statistical analysis of histopathological records of 2,931 patients who underwent uterine curettage between January 2001 and December 2011 at our institution. RESULTS: The risk of endometrial malignancy was about 10 times higher in patients aged 50 years or older than that in younger women. However, women with abnormal uterine bleeding had a higher prevalence of high-risk conditions, regardless of age. CONCLUSION: Atypical and complex endometrial hyperplasia and carcinoma can affect women of all ages, but are more common in patients 50 years of age or older. Thus, endometrial sampling is recommended as a routine procedure for all women 50 years of age or older with clinical indications of the disease and as a screening procedure for those undergoing hysterectomy.