Prevalence of endometrial cancer symptoms among overweight and obese women presenting to a multidisciplinary weight management center
Endometrial cancer rates are rising in parallel with the obesity epidemic. We aimed to determine the prevalence of endometrial hyperplasia or cancer (EH/EC) bleeding symptoms among at-risk women. We conducted a retrospective cohort study of overweight and obese women at a multidisciplinary weight ma...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-11-01
|
| Series: | Gynecologic Oncology Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578920301090 |
| _version_ | 1828921039536521216 |
|---|---|
| author | Anna L. Beavis Omar Najjar Lawrence J. Cheskin Rohan Mangal Anne F. Rositch Geri Langham Amanda N. Fader |
| author_facet | Anna L. Beavis Omar Najjar Lawrence J. Cheskin Rohan Mangal Anne F. Rositch Geri Langham Amanda N. Fader |
| author_sort | Anna L. Beavis |
| collection | DOAJ |
| description | Endometrial cancer rates are rising in parallel with the obesity epidemic. We aimed to determine the prevalence of endometrial hyperplasia or cancer (EH/EC) bleeding symptoms among at-risk women. We conducted a retrospective cohort study of overweight and obese women at a multidisciplinary weight management center who had completed a gynecologic/menstrual history questionnaire from May 2018 to October 2019. The primary outcome of any EH/EC symptom was defined as follows: in premenopausal women, any recent abnormal uterine bleeding (AUB); in postmenopausal women: any bleeding/discharge. The prevalence of EH/EC symptoms was compared by menopausal status using Fisher’s exact tests, and multivariable regression identified independent factors associated with having EH/EC symptoms. A total of 103 women were included, and 4 (4%) had a history of EH/EC. Of the 84 (n = 82%) of women with no prior hysterectomy, 57% (n = 33/58) of premenopausal women reported any EH/EC symptom compared to 15% (n = 15/26) of postmenopausal women (p < 0.001). Two-thirds of symptomatic premenopausal women had two or more symptoms, most commonly heavy menses (49% (n = 25/51)) and irregular periods (39% (n = 17/44)). Sixty percent (n = 20/33) had discussed these with a gynecologist, and one third had undergone an endometrial biopsy. A history of polycystic ovarian syndrome (RR:1.72, 95% CI 1.24–2.38) was associated with EH/EC symptoms, while being postmenopausal was not (RR:0.32, 95%CI: 0.12–0.87). We demonstrate that EH/EC bleeding symptoms are prevalent in this at-risk population, but frequently are not discussed with gynecologists. Providers who care for obese women should ask about EH/EC symptoms, and provide prompt referrals to facilitate prevention and early detection of this cancer. |
| first_indexed | 2024-12-13T21:57:07Z |
| format | Article |
| id | doaj.art-fa258c0d26c74e21a2fca78d9f3e390d |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-12-13T21:57:07Z |
| publishDate | 2020-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-fa258c0d26c74e21a2fca78d9f3e390d2022-12-21T23:30:07ZengElsevierGynecologic Oncology Reports2352-57892020-11-0134100643Prevalence of endometrial cancer symptoms among overweight and obese women presenting to a multidisciplinary weight management centerAnna L. Beavis0Omar Najjar1Lawrence J. Cheskin2Rohan Mangal3Anne F. Rositch4Geri Langham5Amanda N. Fader6The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Corresponding author at: 600 North Wolfe St, Phipps 281, Baltimore, MD 21287, USA.The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Nutrition and Food Services, College of Health and Human Services, George Mason University, Fairfax, VA, USAJohns Hopkins University, Baltimore, MD, USADepartment Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAMeharry Medical College School of Medicine, Nashville, TN, USAThe Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USAEndometrial cancer rates are rising in parallel with the obesity epidemic. We aimed to determine the prevalence of endometrial hyperplasia or cancer (EH/EC) bleeding symptoms among at-risk women. We conducted a retrospective cohort study of overweight and obese women at a multidisciplinary weight management center who had completed a gynecologic/menstrual history questionnaire from May 2018 to October 2019. The primary outcome of any EH/EC symptom was defined as follows: in premenopausal women, any recent abnormal uterine bleeding (AUB); in postmenopausal women: any bleeding/discharge. The prevalence of EH/EC symptoms was compared by menopausal status using Fisher’s exact tests, and multivariable regression identified independent factors associated with having EH/EC symptoms. A total of 103 women were included, and 4 (4%) had a history of EH/EC. Of the 84 (n = 82%) of women with no prior hysterectomy, 57% (n = 33/58) of premenopausal women reported any EH/EC symptom compared to 15% (n = 15/26) of postmenopausal women (p < 0.001). Two-thirds of symptomatic premenopausal women had two or more symptoms, most commonly heavy menses (49% (n = 25/51)) and irregular periods (39% (n = 17/44)). Sixty percent (n = 20/33) had discussed these with a gynecologist, and one third had undergone an endometrial biopsy. A history of polycystic ovarian syndrome (RR:1.72, 95% CI 1.24–2.38) was associated with EH/EC symptoms, while being postmenopausal was not (RR:0.32, 95%CI: 0.12–0.87). We demonstrate that EH/EC bleeding symptoms are prevalent in this at-risk population, but frequently are not discussed with gynecologists. Providers who care for obese women should ask about EH/EC symptoms, and provide prompt referrals to facilitate prevention and early detection of this cancer.http://www.sciencedirect.com/science/article/pii/S2352578920301090ObesityUterine cancerEndometrial cancerBariatric surgeryEndometrial hyperplasiaEndometrial intraepithelial neoplasia |
| spellingShingle | Anna L. Beavis Omar Najjar Lawrence J. Cheskin Rohan Mangal Anne F. Rositch Geri Langham Amanda N. Fader Prevalence of endometrial cancer symptoms among overweight and obese women presenting to a multidisciplinary weight management center Gynecologic Oncology Reports Obesity Uterine cancer Endometrial cancer Bariatric surgery Endometrial hyperplasia Endometrial intraepithelial neoplasia |
| title | Prevalence of endometrial cancer symptoms among overweight and obese women presenting to a multidisciplinary weight management center |
| title_full | Prevalence of endometrial cancer symptoms among overweight and obese women presenting to a multidisciplinary weight management center |
| title_fullStr | Prevalence of endometrial cancer symptoms among overweight and obese women presenting to a multidisciplinary weight management center |
| title_full_unstemmed | Prevalence of endometrial cancer symptoms among overweight and obese women presenting to a multidisciplinary weight management center |
| title_short | Prevalence of endometrial cancer symptoms among overweight and obese women presenting to a multidisciplinary weight management center |
| title_sort | prevalence of endometrial cancer symptoms among overweight and obese women presenting to a multidisciplinary weight management center |
| topic | Obesity Uterine cancer Endometrial cancer Bariatric surgery Endometrial hyperplasia Endometrial intraepithelial neoplasia |
| url | http://www.sciencedirect.com/science/article/pii/S2352578920301090 |
| work_keys_str_mv | AT annalbeavis prevalenceofendometrialcancersymptomsamongoverweightandobesewomenpresentingtoamultidisciplinaryweightmanagementcenter AT omarnajjar prevalenceofendometrialcancersymptomsamongoverweightandobesewomenpresentingtoamultidisciplinaryweightmanagementcenter AT lawrencejcheskin prevalenceofendometrialcancersymptomsamongoverweightandobesewomenpresentingtoamultidisciplinaryweightmanagementcenter AT rohanmangal prevalenceofendometrialcancersymptomsamongoverweightandobesewomenpresentingtoamultidisciplinaryweightmanagementcenter AT annefrositch prevalenceofendometrialcancersymptomsamongoverweightandobesewomenpresentingtoamultidisciplinaryweightmanagementcenter AT gerilangham prevalenceofendometrialcancersymptomsamongoverweightandobesewomenpresentingtoamultidisciplinaryweightmanagementcenter AT amandanfader prevalenceofendometrialcancersymptomsamongoverweightandobesewomenpresentingtoamultidisciplinaryweightmanagementcenter |