Use of ultrasonographic cut point for diagnosing endometrial pathology in postmenopausal women with multiple risk factors for endometrial cancer.

OBJECTIVE: To determine if the established endometrial thickness cut point (5 mm) for abnormal endometrial pathology shifts to higher thickness hi the presence of selected risk factors/comorbidities. STUDY DESIGN: A sample of 112 postmenopausal women was idetified. The outcome was abnormal endometrial pathology, be it endometrial cancer or hyperplasia with atypia. Logistic regression was used to calculate prevalence odds ratios (ORs) of abnormal results for women with thick or thin endometria and 0 or >= 1 of the following comorbidities/cofactors: obesity, diabetes, hypertension mid use of hormone replacement therapy. RESULTS: Approximately half the sample was hypertensive; 56.3% were obese. A large proportion (84.8%) of the patients had >= 1 of the comorbidities/cofactors of interest. Women with endometria >= 12 mm and >= 1 comorbidities appeared to have 5 times the odds of having an abnormal result compared to women with thin endometrin (< 12 mm) who had 0 comorbidities; this result was not statistically significant (adjusted OR = 5.08, p = 0.07). A dose-response curve (regression spline) showed that the prevalence of an abnormal outcome increased sharply between 5 mid 9 mm. CONCLUSION: Clinicians should continue to use the 5-mm cut point when deciding whether patients should have endometrial sampling. (J Reprod Med 2008;53: 755-759)