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Common Causes of Postmenopausal Bleeding in Korean Women: 10-Year Outcomes from a Single Medical Center

View Article: PubMed Central - PubMed

ABSTRACT

The common causes of postmenopausal bleeding (PMB), according to the data from the western world, are atrophy, hormone replacement therapy (HRT), endometrial cancer, etc. We conducted a retrospective study to assess whether the causes of PMB in Korean postmenopausal women are similar to those already known. This retrospective study used 10-year medical records (March 2005 to December 2014) of 792 PMB women in the Yonsei University Health System. The data were divided into 2 categories by 5-year intervals to compare the differences between the 2 periods. The most common cause of PMB in Korean women was atrophy (51.1%). Polyps and HRT were the second, followed by anticoagulant medications, cervical cancer, and endometrial cancer. The proportion of patients with cervical cancer significantly decreased during the second half of the decade (8.7% vs. 5.2%; P = 0.048). Although no significant change was noted for HRT, its rank was higher during the latter 5-year period. Only the most common cause of PMB was the same as the conventional data. Interestingly, the proportion of patients with cervical cancer decreased during the latter half of the decade, reflecting the changes in the nation's cancer prevalence rate, while the use of HRT increased.

No MeSH data available.


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Sonographic characteristics of endometrial cancer patients' endometrium.
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Figure 2: Sonographic characteristics of endometrial cancer patients' endometrium.

Mentions: Among the endometrial cancer patients in the study population, the average endometrial thickness (ET) including the mass size measured by gynecologic sonography was 48 mm. Sixty-six percent of patients were shown to have an endometrial mass and 78.7% had ET more than 10 mm (Fig. 2). The percentages of patients with ET ≥ 5 mm and < 10 mm, and < 5 mm were 8.5% and 12.8%, respectively. Various reports debated the most sensitive cut-off value for ET to detect endometrial cancer by sonography. An optimal cut-off of 5 mm is being proposed (418) and our data clearly exceeds this limit. Hysteroscopy also aids the diagnosis, allowing visual confirmation and endometrial biopsy during the procedure, evidently increasing the screening sensitivity (781018). For patients without PMB, the 5 mm cut-off could be recommended as described from previous studies (418). However, since this study result reveals that certain number of patients with ET less than 5 mm were also found to have cancer, biopsy can be considered even in patients with ET < 5 mm when PMB coexists. Further prospective studies will be needed to confirm this.


Common Causes of Postmenopausal Bleeding in Korean Women: 10-Year Outcomes from a Single Medical Center
Sonographic characteristics of endometrial cancer patients' endometrium.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383617&req=5

Figure 2: Sonographic characteristics of endometrial cancer patients' endometrium.
Mentions: Among the endometrial cancer patients in the study population, the average endometrial thickness (ET) including the mass size measured by gynecologic sonography was 48 mm. Sixty-six percent of patients were shown to have an endometrial mass and 78.7% had ET more than 10 mm (Fig. 2). The percentages of patients with ET ≥ 5 mm and < 10 mm, and < 5 mm were 8.5% and 12.8%, respectively. Various reports debated the most sensitive cut-off value for ET to detect endometrial cancer by sonography. An optimal cut-off of 5 mm is being proposed (418) and our data clearly exceeds this limit. Hysteroscopy also aids the diagnosis, allowing visual confirmation and endometrial biopsy during the procedure, evidently increasing the screening sensitivity (781018). For patients without PMB, the 5 mm cut-off could be recommended as described from previous studies (418). However, since this study result reveals that certain number of patients with ET less than 5 mm were also found to have cancer, biopsy can be considered even in patients with ET < 5 mm when PMB coexists. Further prospective studies will be needed to confirm this.

View Article: PubMed Central - PubMed

ABSTRACT

The common causes of postmenopausal bleeding (PMB), according to the data from the western world, are atrophy, hormone replacement therapy (HRT), endometrial cancer, etc. We conducted a retrospective study to assess whether the causes of PMB in Korean postmenopausal women are similar to those already known. This retrospective study used 10-year medical records (March 2005 to December 2014) of 792 PMB women in the Yonsei University Health System. The data were divided into 2 categories by 5-year intervals to compare the differences between the 2 periods. The most common cause of PMB in Korean women was atrophy (51.1%). Polyps and HRT were the second, followed by anticoagulant medications, cervical cancer, and endometrial cancer. The proportion of patients with cervical cancer significantly decreased during the second half of the decade (8.7% vs. 5.2%; P = 0.048). Although no significant change was noted for HRT, its rank was higher during the latter 5-year period. Only the most common cause of PMB was the same as the conventional data. Interestingly, the proportion of patients with cervical cancer decreased during the latter half of the decade, reflecting the changes in the nation's cancer prevalence rate, while the use of HRT increased.

No MeSH data available.


Related in: MedlinePlus