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Details

Name
11750 - Office Hysteroscopy: Its Relevance As a Screening Method in High-Risk Asymptomatic Patients
Presenting Author
Jorge Dotto, Sr
Affiliation
IADT Instituto Argentino de Diagnostico y Tratamiento
Abstract

Study Objective: To develop a screening strategy for high-risk asymptomatic patients for endometrial cancer.

Design: Single Prospective Cohort

Setting: Gynecological Medical Office. We did not use anesthesia.

Patients or Participants: We developed screening protocol for high-risk asymptomatic patients, conducting triennial screenings with OH from Jan 2003 to Jan 2023. Used Dotto et al. Classification for HysteroscopicRisk Assessment. Studied 2076 high-risk patients (35-65 yo, mean age 51.4 yo) with risk factors including obesity, diabetes, cancer history, tamoxifen use, PCOS, HRT. Hypertension required an additional risk factor for enrollment. 41 patients excluded; final population 2035. All asymptomatic at recruitment. Diagnosed patients with endometrial cancer were removed from program for treatment..

Interventions: Office Hysteroscopy

Measurements and Main Results: Screening protocol for high-risk asymptomatic patients for endometrial cancer, performing a screening office (OH) every three years in the targeted group. Between 2003 and 2023 we performed a total of 14439 OH in high-risk patients for endometrial cancer. Findings: 2003 : 27 AH (Atypical Hyperplasia ) 24 CA (carcinomas) PMDR 2.5% (Premalignant + Malignant Detection Rate ) 2006: AH 22 CA 16 PMDR 1.93% , 2009 AH 24 CA 18 PMDR 2.25% , 2012: AH 27 CA14 PMDR 3.32%, 2015 AH 23 CA 13 PMDR 2.09%, 2018 AH 29 CA 22 PMDR 3% 2021 AH26 CA 15 PMDR 2.54% 2023: AH 28 CA 31 PMDR 3.66%

Conclusion: We propose the use of office hysteroscopy as a screening method for high-risk for endometrial cancer asymptomatic patients. OH has the capacity of detecting lesions at an earlier stage, this widens the therapeutic window providing the patients with a greater chance of cure. This technique allowed us to diagnose endometrial cancer and premalignant lesions that were missed by transvaginal ultrasound.

Authors

Jorge E Dotto Sr., MD PhD Prof, Paola G Da Graca Mila, MD, PhD and Miguel a Bigozzi Jr., MD, PhD, Hysteroscopy, IADT Instituto Argentino de Diagnostico y Tratamiento, Buenos Aires, Buenos Aires, Argentina

Primary Category
Hysteroscopy
Secondary Category
Onocology
Sponsorship Level
Virtual Poster
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11750 - Office Hysteroscopy: Its Relevance As a Screening Method in High-Risk Asymptomatic Patients
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