Malignancy Risk of Endometrial Polyps Among Geriatric Women

Abstract

Summary: Background: The population of elderly women is increasing worldwide. Here we investigated the prevalence of malignant endometrial polyps in a population of geriatric women. Methods: This retrospective study was conducted at the gynaecology clinic of Zekai Tahir Burak Education and Research Hospital. Women who were aged >65 years and who were pathologically diagnosed with endometrial polyps between 2007 and 2016 were included. All patients with endometrial polyps underwent hysteroscopic resection. Patient characteristics, complaints and imaging and surgical findings were obtained from their medical records. Statistical data analysis was performed using SPSS software. Results: In total, 133 geriatric female patients were included. They had a mean age of 68.96 ± 4.20 (65–83) years. Among them, 114 (85.7%) patients had benign endometrial polyps, 7 (5.2%) had endometrial hyperplasia and 12 (9%) had endometrial cancer. Forty-eight women had been admitted because of postmenopausal bleeding. Eighty-five women presented with either non-specific symptoms, such as abdominal pain, dysuria and urinary incontinence, or had no symptoms and received incidental diagnosis via ultrasound scanning. The mean endometrial thickness was 9.3 ± 6.39 mm in benign cases and 16.44 ± 8.64 mm in premalignant/malignant cases. In multivariate Cox regression analysis, uterine bleeding and endometrial thickness were significantly and independently associated with premalignant or malignant polyps.All malignant polyps were found to be endometrioid adenocarcinoma. Conclusion: In our study, we detected an prevalence of endometrial cancer among 9% of geriatric women with endometrial polyps. Hence, it is important to conduct a pathological evaluation of endometrial polyps in such patients. Keywords: geriatrics, postmenopausal period, polyps, neoplasms