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Is There a Survival Advantage in Diagnosing Endometrial Cancer in Asymptomatic Patients? A Systemic Review and Meta-analysis
- Source :
- Journal of Obstetrics and Gynaecology Canada. 42:481-487.e2
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Data supporting a survival advantage of endometrial cancer diagnosed before the onset of postmenopausal bleeding are lacking. This study sought to compare overall survival and disease recurrence between women who were asymptomatic at diagnosis and women who were symptomatic at diagnosis. A systemic search was conducted in databases using the terms: "asymptomatic," "ultrasound," "screening," and "endometrial cancer." Only original research studies that compared characteristics of tumour advancement and survival measures were included. The six articles included in the meta-analysis comprised 2961 patients. Data were collected on study design and period, number and characteristics of participants, and outcomes in terms of tumour histology and survival measures. Higher rates of stage I tumours were shown among asymptomatic patients (relative risk 1.19). The proportion of high-grade histology did not differ between the two groups (relative risk 0.92). The crude pooled estimate for overall survival did not yield statistical significance, nor did recurrence-free survival (which was reported by three studies). In conclusion, endometrial cancer diagnosed in asymptomatic women is not associated with higher survival than in symptomatic women. Invasive procedures in asymptomatic women with incidental ultrasonographic findings should be carefully weighed because no survival advantage is expected.
- Subjects :
- medicine.medical_specialty
Disease
Original research
Asymptomatic
Disease-Free Survival
Endometrium
03 medical and health sciences
Polyps
0302 clinical medicine
Statistical significance
Internal medicine
Humans
Medicine
Survival advantage
030212 general & internal medicine
Early Detection of Cancer
Ultrasonography
030219 obstetrics & reproductive medicine
business.industry
Endometrial cancer
Obstetrics and Gynecology
medicine.disease
Survival Analysis
Endometrial Neoplasms
Meta-analysis
Relative risk
Asymptomatic Diseases
Female
Uterine Hemorrhage
medicine.symptom
business
Subjects
Details
- ISSN :
- 17012163
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Journal of Obstetrics and Gynaecology Canada
- Accession number :
- edsair.doi.dedup.....48ef3de03b7a520aeabf9018a7c88807