Womb condition checks could reduce cancer risk in endometrial hyperplasia

Women with atypical endometrial hyperplasia have an increased risk of developing cancer

Researchers from the University of Edinburgh have revealed that improved patient care is needed to reduce cancer risk among women with endometrial hyperplasia in a new study.

The study compared the treatment that patients living with the condition received before and after the introduction of national guidance.

Grouped into two types, atypical endometrial hyperplasia is a precancerous condition that carries an increased risk, and non-atypical endometrial hyperplasia occurs when the womb lining is thicker than normal but less likely to become cancerous.

Currently, in the UK, the national guidance for this condition recommends a hysterectomy, a surgical procedure that removes the womb, for patients with atypical endometrial hyperplasia.

For those with non-atypical endometrial hyperplasia, guidance recommends a trial of a hormone treatment given directly into the womb, with regular follow-up monitoring to track progress.

The study analysed patient records from more than 3,000 people across the UK diagnosed with endometrial hyperplasia between 2012 and 2020, 50% of whom had non-atypical endometrial hyperplasia and the other half had atypical.

Non-atypical endometrial hyperplasia patients who had hormone treatment increased from 38% to 53% after the UK national guidelines were introduced, while hysterectomy surgery for atypical patients was reduced by 1% between 2012 and 2015 and 2016 and 2019.

At the start of the COVID-19 pandemic in 2020, hysterectomy surgery for endometrial hyperplasia patients had dropped to 52%.

Researchers then revealed that only one in five women with the condition who did not have a hysterectomy received the recommended schedule of follow-up monitoring and biopsies, while 37% who did receive a hysterectomy between 2016 and 2019 showed evidence of cancer when their wombs were analysed after surgery.

Dr Michael Rimmer from the University of Edinburgh’s Centre for Reproductive Health emphasised the importance of improved follow-up monitoring: “When treating women with endometrial hyperplasia…, there is a need for better care for women not undergoing a hysterectomy – particularly considering the risk of developing cancer in the future for these women.”