Bottom Line: Postmenopausal bleeding is a common symptom among most women with endometrial cancer but most women with postmenopausal bleeding won't be diagnosed with endometrial cancer, findings that raise questions about how to best manage postmenopausal bleeding for the early detection of endometrial cancer.
Why The Research Is Interesting: Endometrial cancer diagnosed early is often curable with surgery but five-year survival rates plummet for late-stage disease. Accurate estimates of the frequency of postmenopausal bleeding in endometrial cancers and the risk of endometrial cancer in women with postmenopausal bleeding are needed to evaluate whether targeting women with postmenopausal bleeding for early detection is a useful strategy.
Who and When: Nearly 41,000 from 129 studies (34,000 women with postmenopausal bleeding and more than 6,000 women with endometrial cancer)
What (Measures and Outcomes): Pooled frequency of postmenopausal bleeding in women with endometrial cancer and the risk of endometrial cancer in women with postmenopausal bleeding
How (Study Design): This was a systematic review and meta-analysis. A meta-analysis combines the results of multiple studies identified in a systematic review and quantitatively summarizes the overall association between the same exposure and outcomes measured across all studies.
Authors: Megan A. Clarke, Ph.D., M.H.S., of the National Cancer Institute, Rockville, Maryland, and coauthors
Results: The pooled frequency of postmenopausal bleeding among women with endometrial cancer was 91 percent, while the pooled risk of endometrial cancer among women with postmenopausal bleeding was 9 percent.
Study Limitations: Some data were inconsistently reported and other available data were insufficient.
Related Material: The invited commentary, "Opportunities for Early Detection of Endometrial Cancer in Women with Postmenopausal Bleeding," by Kristen A. Matteson, Women and Infants Hospital, Providence, Rhode Island, and coauthors is available on the For The Media website.
To Learn More: The full study is available on the For The Media website.
(doi:10.1001/jamainternmed.2018.2820)
Editor's Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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Journal
JAMA Internal Medicine