Most Postmenopausal Bleeding Not Associated With Cancer

Most women with postmenopausal bleeding (PMB) will not be diagnosed with endometrial cancer, according to a review published online Aug. 6 in JAMA Internal Medicine.

Megan A. Clarke, Ph.D., from the National Cancer Institute in Rockville, Md., and colleagues conducted a systematic literature review and meta-analysis to provide a reference of the prevalence of PMB in endometrial cancers and the risk of endometrial cancer in women with PMB. The authors analyzed 129 observational studies, including 34,432 unique patients with PMB and 6,358 with endometrial cancer.

The researchers found that the pooled prevalence of PMB among women with endometrial cancer was 91 percent, irrespective of tumor stage. Among women with PMB, the pooled risk of endometrial cancer was 9 percent, with estimates varying by use of hormone therapy (range, 7 percent; P < 0.001 for heterogeneity) and geographic region (range, 5 percent in North America to 13 percent in Western Europe; P = 0.09 for heterogeneity).

"These results can aid in the assessment of the potential clinical value of new early detection markers and clinical management strategies for endometrial cancer and will help to inform clinical and epidemiologic risk prediction models to support decision making," the authors write.

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