ArticleCureus2025
Clinical, Metabolic, and Sonographic Predictors of Endometrial Carcinoma Among Women Presenting With Postmenopausal Bleeding: A Prospective Observational Study From a Tertiary Care Center in South India.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background Endometrial carcinoma represents the most common gynecological malignancy among postmenopausal women, with rising incidence attributed to increasing rates of obesity, metabolic syndrome, and changing reproductive patterns. Identifying clinical and metabolic risk factors is essential for early diagnosis and improved outcomes. This study aims to evaluate the clinical, demographic, and metabolic risk factors associated with endometrial carcinoma in postmenopausal women presenting with vaginal bleeding and to correlate bleeding patterns, endometrial thickness (ET), and histopathological findings. Methods This prospective observational study was conducted over 18 months at a tertiary care teaching hospital in South India. Ninety-one postmenopausal women with vaginal bleeding underwent detailed clinical evaluation, transvaginal sonography for ET assessment, and endometrial sampling for histopathological diagnosis. Demographic data, reproductive history, comorbidities, and bleeding patterns were systematically recorded. Statistical analysis was performed using the chi-square test, with a significance threshold of p < 0.05. Results Of the 91 women studied, 16 (17.6%) were diagnosed with endometrial malignancy, while 75 (82.4%) had benign pathology. Malignant cases were significantly associated with higher socioeconomic status, early menarche (10-12 years), late menopause (≥55 years), recurrent postmenopausal bleeding, and positive family history of malignancy. Obesity (BMI ≥30 kg/m²) and combined diabetes with hypertension showed a strong association with malignancy. All malignant cases exhibited ET >5 mm on sonography. Atypical hyperplasia and endometrioid adenocarcinoma were the predominant malignant histologies observed. Conclusions Obesity, metabolic syndrome, reproductive factors, and recurrent bleeding are major risk determinants for endometrial carcinoma in postmenopausal women. Integrating clinical, metabolic, and sonographic criteria can enhance early detection and risk stratification. Focused screening and prevention strategies targeting these risk factors are crucial for reducing disease burden and improving gynecologic care outcomes.
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