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Published on: August 2, 2024
How often are endometrial polyps malignant in asymptomatic postmenopausal women? A multicenter study
Enrico Ferrazzi1, Errico Zupi, Francesco P Leone
1Department of Obstetrics and Gynecology, DSC L. Sacco, University of Milan, Milan, Italy.
American Journal of Obstetrics and Gynecology
|November 26, 2008
Summary
Cancer and premalignant lesions are rare in asymptomatic postmenopausal women with endometrial polyps. Polyp diameter is a key factor in determining abnormal histology, suggesting selective management is possible.
Area of Science:
- Gynecologic Oncology
- Reproductive Endocrinology
Background:
- Endometrial polyps are common in postmenopausal women.
- The risk of malignancy in these polyps is a clinical concern.
Purpose of the Study:
- To determine the prevalence of cancer and premalignant lesions in endometrial polyps of asymptomatic postmenopausal women.
- To compare these findings with symptomatic women experiencing abnormal uterine bleeding.
Main Methods:
- A retrospective multicenter study included 1152 asymptomatic and 770 symptomatic postmenopausal women.
- Hysteroscopic polypectomy was performed based on imaging diagnosis.
- Pathologic reports served as the primary outcome measure.
Main Results:
- Only 0.1% of asymptomatic women had endometrial cancer on polyps, significantly lower than symptomatic patients.
- Atypical hyperplasia prevalence was 1.2% in asymptomatic versus 2.2% in symptomatic women.
- Polyp diameter >18 mm was significantly associated with abnormal histology (OR 6.9).
Conclusions:
- Malignancy and premalignant lesions are infrequent in asymptomatic postmenopausal women with endometrial polyps.
- Management can be selectively based on polyp size, focusing on larger polyps.
- Conservative management may be appropriate for incidentally diagnosed polyps in asymptomatic patients.
