HOLLYWOOD, FLA. – Researchers report a good correlation between hysteroscopy and histopathology in the diagnosis of endometrial cancer among women with postmenopausal bleeding.
An estimated 10%-15% of patients with postmenopausal bleeding have endometrial cancer. “In Brazil, this is the eighth most frequent tumor [type],” said Dr. Raquel P. Dibi, a gynecologist at Complexo Hospitalar Santa Casa de Porto Alegre, a teaching hospital in Porto Alegre, Rio Grande do Sul, Brazil.
Dr. Dibi and her associates compared hysteroscopy and biopsy histopathology findings for 507 patients with postmenopausal bleeding. Hysteroscopy identified 41 (8%) cases suggestive of endometrial cancer, and histology confirmed 30 of these (73%). Hysteroscopy for the diagnosis of endometrial cancer was associated with 94% sensitivity, 98% specificity, a 73% positive predictive value, and a 99.6% negative predictive value.
“A good correlation was observed between hysteroscopy and histological findings,” Dr. Dibi said at the meeting.
With hysteroscopy, the most common findings were endometrial polyps (40%) and atrophic endometrium (34%). With histopathology, almost half of reports came back designated “absent material” (47%); the most common findings also were endometrial polyps (17%) and atrophic endometrium (5%).
“Hysteroscopy has demonstrated efficacy for diagnosis of endometrial cancer, agreeing with studies published by other authors,” Dr. Dibi said.
Patients ranged in age from 43 to 85 years. The mean age at time of menopause was 48 years. The median time since menopause was 9 years in this study.