DETECTION OF ENDOMETRIAL CARCINOMA AND HYPERPLASIA IN ASYMPTOMATIC WOMEN

  • 1 January 1984
    • journal article
    • research article
    • Vol. 64  (1) , 1-11
Abstract
Occult endometrial carcinoma is a detectable disease using commercially available sampling devices and cytohistologic techniques. A cohort of 2586 asymptomatic women (98% past the age of 45, 78% caucasian) was screened. Of these women, 1567 were screened twice, and 187 were screened 3 times. The prevalence and incidence rates of endometrial carcinoma, as defined in the present study, including 4 missed cases, were 6.96/1000 and 1.71/1000 women years, respectively. The prevalence rate was 7.38/1000 for caucasian women and 5.40/1000 for women of other races. An epidemiologic evaluation suggested that the onset of menopause past the age of 49 was the only statistically significant risk factor; race, parity, estrogen intake and obesity, as calculated by the Quetelet index, were not statistically significant. In asymptomatic women past the age of 50, endometrial hyperplasia apparently does not necessarily precede or accompany the development of endometrial carcinoma. Two distinct mechanisms may be responsible for the onset of endometrial cancer: endometrial hyperplasia occurring in the symptomatic and younger woman; and endometrial adenocarcinoma occurring ab initio in the older patient.