Endometrial cancer after endometrial ablation or resection for menorrhagia

Objective: To assess the incidence of endometrial cancer after endometrial ablation or resection (EA/R) for menorrhagia. Method: The present retrospective observational cohort study included women who underwent EA/R for menorrhagia at Aberdeen Royal Infirmary between February 1, 1990 and December 31, 1997. Follow-up data until 2015 were examined. To assess risk of endometrial cancer, each woman was matched by age to the annual observed incidence of endometrial cancer in northeast Scotland for each year from the date of EA/R until 2015. Results: During the 7-year study period, 901 eligible women (mean age 42.3 +/- 5.7 years; range 26-50 years) underwent EA/R. Of these patients, 204 (22.6%) subsequently had a hysterectomy for reasons other than endometrial cancer, and 695 (77.1%) did not. The overall incidence of endometrial cancer was 0.2% (2/901); the risk of developing endometrial cancer after EA/R was calculated as 11.1 per 100 000 women years. The mean expected incidence for all women and the subgroup with no hysterectomy was estimated to be 26.5 and 35.6 occurrences per 100 000 women years, respectively. The observed incidence was significantly lower versus the mean expected risk for both groups (P<0.001). Conclusion: The findings indicate that the risk of endometrial cancer could be significantly reduced but not eliminated by EA/R.