Estimating the Risk of Endometrial Cancer in Symptomatic Postmenopausal Women: A Novel Clinical Prediction Model Based on Patients' Characteristics

Burbos, Nikolaos; Musonda, Patrick; Duncan, Timothy J.; Crocker, Simon G.; Morris, Edward; Nieto, Joaquín J.

doi:10.1097/igc.0b013e31820c4cd6

Cited by 30 publications

(33 citation statements)

References 22 publications

(16 reference statements)

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“…2 Postmenopausal bleeding is the most common symptom of endometrial cancer, but this is a relatively common complaint; and fewer than 10% of women with bleeding after menopause are found to have a cancer. 3 Current noninvasive testing for identifying endometrial cancer with ultrasound imaging in women is useful when the test is negative (the negative predictive value is 999% for women with an endometrial thickness e4 mm), but the value of the imaging is significantly reduced when positive. 4 Many women will be subjected to invasive procedures, such as an endometrial biopsy taken during an endoscopic assessment of the endometrium.…”

mentioning

confidence: 99%

GALR1 Methylation in Vaginal Swabs Is Highly Accurate in Identifying Women With Endometrial Cancer

Doufekas

Hadwin

Kandimalla

et al. 2013

International Journal of Gynecological Cancer

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Endometrial cancer has become the most common gynecological cancer in developed countries. Postmenopausal bleeding is indicative of the disease in only 1 of 10 women with this symptom. A noninvasive tool to identify women with cancer would be highly desirable. We analyzed more than 27,000 CpGs in normal endometrial tissue (n = 23) and endometrial cancers (n = 64) and found that DNA methylation of GALR1 is among the most frequent epigenetic alterations in this cancer. We then developed a real-time polymerase chain reaction-based GALR1 methylation test and applied this test to vaginal swabs from 79 women who presented with postmenopausal bleeding. The receiver operating characteristics area under the curve, describing sensitivity and specificity to correctly identify the 41 women with both premalignant and malignant endometrial changes, was 0.93 (95% confidence interval, 0.87-0.97; P < 0.0001).GALR1 DNA methylation is one of the most common molecular alterations in endometrial cancer, and the presence of GALR1 methylation in vaginal swabs from women with postmenopausal bleeding indicates the presence of endometrial malignancy with a sensitivity of 92.7% and a specificity of 78.9%.

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mentioning

confidence: 99%

GALR1 Methylation in Vaginal Swabs Is Highly Accurate in Identifying Women With Endometrial Cancer

Doufekas

Hadwin

Kandimalla

et al. 2013

International Journal of Gynecological Cancer

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“…Other identified risk factors include obesity, diabetes mellitus, increasing age, nulliparity and hypertension. 22 Since this patient has multiple risk factors for developing endometrial malignancy, the provider can easily use one of the predictive models such as the DFAB (D stands for diabetes mellitus, F for frequency of bleeding episodes, A for age, and B for BMI cut off value of 31) 23,24 to estimate the risk of endometrial cancer (Table 3). DFAB score ≥ 4 has a sensitivity of 81.8% and specificity of 50.8% in detecting endometrial malignancy.…”

Section: What Happens If Ebm Approach Is Used In Management Of This Cmentioning

confidence: 99%

Obstetrics and Gynecology Ultrasound and Evidence-based Medicine in Medical Education

Aragon¹,

Ho²

2014

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Evidence-based medicine (EBM) is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. Despite improvement in knowledge, technology, effective medical therapies and ample practice guidelines, the practice of medicine in all specialties including obstetrics and gynecology (OB/GYN) continues to lag behind along with alarming rate of medical errors. Similarly, ultrasonography is rapidly expanding in the practice of medicine across many specialties but standardized requirements and ultrasound curricula for residency training in obstetrics and gynecology are still lacking.EBM is a required component of the curriculum of medical education at all levels but still does not have a firm foothold in the practice of medicine in the United States and other countries because of barriers. There are many proposed changes to improve the efficacy of current teaching of EBM and ultrasound including an early introduction in preclinical curriculum and integration of a longitudinal EBM-ultrasound training in the continuum of medical education.We present a case of postmenopausal bleeding (PMB) which was managed according to the traditional way, and review of EBM literature to contrast differences in clinical decision of two clinical approaches.

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“…Several prediction models for the risk of developing endometrial cancer have been evaluated in general population, and in women with postmenopausal bleeding . Prediction models can help identifying asymptomatic women at high risk of developing endometrial carcinoma, and as well facilitating early diagnosis in symptomatic women.…”

Section: High‐risk Populationsmentioning

confidence: 99%

“…Several prediction models for the risk of developing endometrial cancer have been evaluated in general population, [56][57][58] and in women with postmenopausal bleeding. [59][60][61][62] Prediction models can help identifying asymptomatic women at high risk of developing endometrial carcinoma, and as well facilitating early diagnosis in symptomatic women. However, current models usually lack external validation, and should probably be extended with new genetic and epigenetic biomarkers in order to improve models performance.…”

Section: High-risk Populationsmentioning

confidence: 99%

New perspectives on screening and early detection of endometrial cancer

Costas

Frias-Gomez

Guardiola

et al. 2019

Intl Journal of Cancer

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Due to the anatomical continuity of the uterine cavity with the cervix, genomic exploitation of material from routine Pap smears and other noninvasive sampling methods represent a unique opportunity to detect signs of disease using biological material shed from the upper genital tract. Recent research findings offer a promising perspective in the detection of endometrial cancer, but certain questions need to be addressed in order to accelerate the implementation of novel technologies in a routine screening or clinical setting. We discuss here new perspectives on detection of endometrial cancer using genomic and other biomarkers in minimally invasive sampling methods with a special focus on public health classic screening criteria, highlighting current gaps in knowledge.

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Estimating the Risk of Endometrial Cancer in Symptomatic Postmenopausal Women: A Novel Clinical Prediction Model Based on Patients' Characteristics

Cited by 30 publications

References 22 publications

GALR1 Methylation in Vaginal Swabs Is Highly Accurate in Identifying Women With Endometrial Cancer

GALR1 Methylation in Vaginal Swabs Is Highly Accurate in Identifying Women With Endometrial Cancer

Obstetrics and Gynecology Ultrasound and Evidence-based Medicine in Medical Education

New perspectives on screening and early detection of endometrial cancer

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