Page 50 - The diagnostic work-up of women with postmenopausal bleeding

Chapter 3
Abstract
Postmenopausal bleeding is associated with an elevated risk of having endometrial cancer.The aim of this review is to give an overview of existing prediction models on endometrial cancer in women with postmenopausal bleeding. In a systematic search of the literature, we identified nine prognostic studies, of which we assessed the quality, the different phases of development and their performance. From these data, we identified the most important predictor variables. None of the detected models completed external validation or impact analysis. Models including power Doppler showed best performance in internal validation,but Doppler in general gynaecological practice is not easy accessible.We can conclude that we have indications that the first step in the approach of women with PMB should be to distinguish between women with low risk versus high risk of having endometrial cancer and the next step would be to refer patients for further (invasive) testing.
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