The prevalence of endometrial hyperplasia and endometrial cancer in women with polycystic ovary syndrome or hyperandrogenism

Objective: Polycystic ovary syndrome may be associated with an increased risk of endometrial hyperplasia and endometrial cancer, but substantial evidence for this remains to be established. We investigated the prevalence of endometrial hyperplasia and endometrial cancer in a well characterized group of women with polycystic ovary syndrome and/or clinical/biochemical hyperandrogenism.

Design: Retrospective observational trans-sectional study.

Setting: Out-patient clinic at the Departments of Endocrinology and Gynecology, Odense University Hospital, Denmark.

Population: In all, 963 premenopausal women consecutively referred with the diagnoses polycystic ovary syndrome and/or hirsutism during 1997-2008.

Methods: All women underwent a standardized evaluation program. In 2011, The Danish Data Bank of Pathology was used to identify women with endometrial histology diagnoses (year range of diagnosis 1982-2011). Main outcome measures. Histology diagnoses, demographic variables.

Results: Endometrial hyperplasia was diagnosed in 10 (1.0%) women and endometrial cancer in one (0.1%) woman. The median body mass index of these women was 30.6 kg/m(2) compared with 26.8 kg/m(2) in the total cohort. There were no differences between the cases and total cohort in terms of individual Rotterdam Criteria. In Denmark, 70 cases of endometrial cancer are diagnosed yearly in women 40-55 years, a prevalence of 0.4% in the corresponding period.

Conclusion: The results of the present study do not suggest a higher prevalence of endometrial cancer in women with polycystic ovary syndrome and/or clinical/biochemical hyperandrogenism than in the general population.