Abstract

Introduction: Postmenopausal uterine bleeding is a „cancer until proven otherwise“. Endometrial cancer is a typical disease among postmenopause woman, because every bleeding in this age etiology associated with endometrial cancer (10-30%). The lifespan of women today has been extended and post menopause today last one third of a woman’s life. Early diagnosis of endometrial cancer has a very high cure rate. Screening for this cancer has limits in practice and is necessary given the definition of high-risk groups would be subject to primary and secondary prevention. Goal: Primary to evaluate the leading causes of postmenopausal uterine bleeding among patients at risk for endometrial cancer (diabetes, obesity, nulliparity, late menopause (after 55 years) and compared them with the causes of postmenopausal uterine bleeding patients without this risk. Material and methods: A retrospective, descriptive study with a targeted sample of 50 consecutive patients who had registered postmenopausal uterine bleeding in high-risk groups (cohorts) and the same number of patients with postmenopausal uterine bleeding that does not belong to the risk group (control group). Each patient underwent clinical examination, then fractionated curettements and its histopathological verification and assessment of treated clinical stage of disease with PH analysis of the resected specimens. Results: The patients of the studied risk group were significantly affected by endometrial cancer compared with the control group (RR=2.45, 95% CI 1.2 4.6, p=0.005). Endocervical pathology did not differ between groups. Clinical forms of bleeding: for those that are profuse bleeding cancer was present in 54.6% of cases. With intermittent bleeding cancer is verified in the 33.3% of patients. Risk patient groups with cancer frequently suffer from clinically more advanced stages of histologically aggressive endometrial cancer (serous adenocarcinoma–type II, low differentiated cancer).

Key words: postmenopausal bleeding, endometrial cancer, risk factors, clinical forms of bleeding.