Necropsy Diagnosis of Endometrial Cancer and Detection-Bias in Case/Control Studies

Horwitz, RalphI.; Horwitz, SarahM.; Feinstein, A R; Robboy, Satnley J.

doi:10.1016/s0140-6736(81)90412-8

Cited by 86 publications

(20 citation statements)

References 4 publications

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“…This study clearly shows how detection bias may have been neglected in other retrospective studies, leading to the conclusion that the magnitude of the association between estrogens and endometrial cancer has been greatly overestimated. This has been at least partially confirmed in a study based on 8998 necropsies in which undetected endometrial cancer was observed 4 to 5 times more frequently than endometrial cancer is diagnosed during life (Horwitz et al 1981). It is interesting to note that their RR of 1.7 is similar to the RR of 1.8 reported in the prospective study by Gambrell (1988).…”

Section: Endometrial Carcinomasupporting

confidence: 72%

Sex Steroids and Cancer in Older Women

Varma

1992

Drugs & Aging

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Menopause and hormone replacement therapy (HRT) continue to be controversial subjects. The main concern is the potential risk of prolonged HRT and the possible development of endometrial and breast carcinoma. There is no obvious evidence at present to suggest that HRT increases endometrial carcinoma provided the patient receives progestogen for a period of 10 or more days (usual period is 12 days) during each month. However the breast does not seem to enjoy this safety margin and there is some concern about possible increase in the incidence of breast cancer if the treatment period is longer than 5 years. The increase in the risk is higher after 15 years of estrogen use. There is no obvious adverse effect on the ovary or on the cervix following HRT.

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Section: Endometrial Carcinomasupporting

confidence: 72%

Sex Steroids and Cancer in Older Women

Varma

1992

Drugs & Aging

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“…All necropsy-based studies have inherent limitations. Mortality data may give a dis torted reflection of the incidence of a disease within a community [7], and necropsy data may even give a distorted reflection of mortal ity [8]. A generalised reduction in necropsy rates in many countries has led to an in creased selectivity of patients undergoing post-mortem examination.…”

Section: Discussion and C Onclusionsmentioning

confidence: 99%

The Changing Pattern of Venous Thromboembolic Disease

Cohen

Edmondson²,

Phillips³

et al. 1996

Pathophysiol Haemos Thromb

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A review of 14,667 necropsy reports for every year from 1965 to 1990 and 6,436 diagnostic venograms performed from 1976 to 1990 was undertaken at a single teaching hospital. A progressive reduction in the percentage of necropsies reporting fatal pulmonary embolism from 6.1 to 2.1 %, occurred over the 25-year period (χ² tests for linear trend with time p < 0.00001). Over the last decade, there has been a significant reduction in the rate of venographically diagnosed postoperative deep vein thrombosis (DVT) from 49.9 to 24.7 per 100,000 population (p < 0.0001) which was in marked contrast to the constant rate of non-postoperative DVT. Our findings suggest that the introduction of thromboprophylactic measures, in addition to changes in hospital practice, may have had a highly significant effect on the pattern of this serious, but potentially avoidable disease.

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“…Other retrospective analyses have also shown no difference in disease-free or overall survival between asymptomatic patients and those with PMB [8,9]. Ultimately a significant number of endometrial carcinomas may never become clinically apparent, as was shown in an autopsy study that found a 4-6 times higher incidence [6,10]. In summary, current data do not support ultrasound screening for endometrial carcinoma and further investigation of incidental endometrial thickening in the absence of PMB provides no benefit.…”

Section: Is Biopsy Indicated For Endometrial Thickening In Postmenopamentioning

confidence: 55%

Current Issues in the Diagnosis and Treatment of Endometrial Carcinoma

Stubert¹,

Gerber²

2016

Geburtshilfe Frauenheilkd

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Zielführend für die Diagnose des Endometriumkarzinoms ist in der überwiegenden Zahl der Fäl-Zusammenfassung ! Das Endometriumkarzinom ist das häufigste Karzinom des weiblichen Genitales. Führendes klinisches Zeichen ist die postmenopausale Blutung. Für die Diagnosestellung ist immer eine Endometriumbiopsie notwendig. Die Therapieentscheidung hängt von der Risikoeinschätzung des Karzinoms und der häufig vorliegenden Komorbidität ab. In Fällen mit niedrigem Risiko (Definition: pT1 a, G1/2) ist eine pelvine und paraaortale Lymphknotendissketion unnötig. Eine adjuvante Bestrahlung und eine Systemtherapie sind zumeist vermeidbar. Die Behandlung von Hochrisikopatientinnen (G3 und/oder pT1b) und von Patientinnen in palliativer Situation ist schwierig und weniger gut standardisiert. Neue, molekular definierte Subtypen könnten hier zukünftig Therapieentscheidungen erleichtern.

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Necropsy Diagnosis of Endometrial Cancer and Detection-Bias in Case/Control Studies

Cited by 86 publications

References 4 publications

Sex Steroids and Cancer in Older Women

Sex Steroids and Cancer in Older Women

The Changing Pattern of Venous Thromboembolic Disease

Current Issues in the Diagnosis and Treatment of Endometrial Carcinoma

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