Detection of postmenopausal women at risk for endometrial carcinoma by a progesterone challenge test

Currently, there exists no convenient, inexpensive screening test for the detection of postmenopausal women at risk for developing adenocarcinoma of the endometrium. After the administration of a progesterone challenge test (PCT) to asymptomatic postmenopausal women, the presence or absence of withdrawal bleeding may aid in detecting premalignant lesions of the endometrium. Of 30 such women who had endometrial sampling followed by a PCT, 25 had no withdrawal bleeding and all had nonpathologic histology. Five patients exhibited withdrawal bleeding. Of these five, three had unsuspected adenomatous hyperplasia (p less than 0.001). It is concluded that a PCT may be a reliable screening test for detecting those women at greater risk for developing endometrial hyperplasia or adenocarcinoma.