Progesterone challenge test in postmenopausal women at high risk

Endometrial carcinoma is one of the commonest cancers of the female genital tract. There is an increasing need for a non-invasive screening test that is suitable for widespread use, especially in postmenopausal women at high risk. The aim of this study was to test the validity of the progesterone challenge test (PCT) for this purpose. The test was performed in 100 postmenopausal women at risk, and the results were compared with histopathology findings. Atrophic endometrium was found only in the PCT-negative cases, while all the PCT-positive cases showed different morphological patterns histologically, viz., proliferative endometrium (1 case), cystic glandular hyperplasia (4 cases), adenomatous hyperplasia (5 cases), atypical hyperplasia (1 case) and adenocarcinoma (1 case). Using the McNemar test, we found the sensitivity of the PCT to be 91.2% and the specificity to be 100%. The results of this study suggest that the progesterone challenge test is a reliable, non-invasive, easy-to-use endometrial screening test for all postmenopausal women, and especially the high-risk group.