First-time postmenopausal bleeding as a clinical marker of long-term cancer risk: A Danish Nationwide Cohort Study

Abstract

Background Data on long-term risk of cancer after a postmenopausal bleeding diagnosis are sparse. Methods We used Danish medical registries to conduct a population-based cohort study of women with a first hospital-diagnosed postmenopausal bleeding during 1995–2013. We computed the absolute risk of cancer and the standardised incidence ratio (SIR) comparing the observed cancer incidence with that expected in the general population. Results Among 43,756 women with postmenopausal bleeding, the absolute 1- and 5-year risk of endometrial cancer were 4.66% and 5.18%, respectively. The SIR of endometrial cancer was elevated during 0–3 months (SIR = 330.36 (95% CI: 315.43–345.81)), 3–12 months (SIR = 11.39 (95% CI: 9.79–13.17)), 1–5 years (SIR = 2.55 (95% CI: 2.19–2.94)) and >5 years of follow-up (SIR = 1.63 (95% CI: 1.40–1.90)). All selected gynaecological and urological, gastrointestinal and haematological cancers had elevated 0–3 months SIRs. Beyond 1 year of follow-up the SIRs of ovarian and bladder cancer remained elevated with a 1–5-year SIR of 2.15 (95% CI: 1.71–2.65) and 1.45 (95% CI: 1.14–1.80), respectively. Conclusions In the Danish population, women with a first hospital-diagnosed postmenopausal bleeding have an increased 0–3 months risk of gynaecological, urological, gastrointestinal and haematological cancers. The SIR of endometrial, ovarian and bladder cancer remained elevated for several years.

Endometrial thickness and uterine artery Doppler parameters as soft markers for prediction of endometrial cancer in postmenopausal bleeding women: a cross-sectional study at tertiary referral hospitals from Vietnam

“…In 2020, GLOBOCAN estimated 417,000 new cases and 97,000 deaths, and the incidence has increased in many countries [ 1 ]. The older the woman with postmenopausal bleeding (PMB), the higher the risk of EC [ 2 ]. Fortunately, 95% of EC stage I could be curable by surgery with a 5-year survival rate of 85–91%, and approximately 90% of EC presents with vaginal bleeding.…”

Ultrasound Findings versus Hysteroscopic Guided Endometrial Histopathological Findings in Women with Postmenopausal Bleeding

“…Postmenopausal bleeding (PMB) is uterine bleeding occurring at least one year after menopause. PMB is a common clinical problem, the incidence of spontaneously occurring PMB in the general population can be as high as 10% after menopause (1).…”

Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal Women

“…Approximately 10% of women complaining of PMB have endometrial carcinoma. 3 Uterine malignancy is the sixth most prevalent cancer of women and the 14th most prevalent cancer throughout the world. 4 A thorough history and physical examination are essential to assess the risk of cancer in women presenting with PMB.…”