The additional value of endometrial sampling in the early detection of endometrial cancer in women with Lynch syndrome

Gynecol Oncol. 2013 Nov;131(2):304-8. doi: 10.1016/j.ygyno.2013.05.032. Epub 2013 Jun 13.


Objective: Based on previous studies, standard gynecological screening consisting of annual transvaginal ultrasonography (TVU) was added with endometrial sampling in women with Lynch syndrome (LS). The aim of this study was to evaluate the additional value of endometrial sampling in detecting (pre)malignancies of the endometrial tissue in women with LS or first-degree relatives.

Methods: All women above 30 years of age with LS or first-degree relatives at 50% risk of LS are offered annual gynecological screening in our family cancer clinic. Endometrial screening results from January 2003-December 2007 (period I: standard screening by transvaginal sonography and serum CA125) were compared with screening results from January 2008-June 2012 (period II: standard screening added with endometrial sampling).

Results: Seventy five women (300 patient years) were screened annually. There were 266 screening visits, 117 in period I and 149 in period II. In period I, four premalignant endometrial lesions were detected and one endometrial carcinoma (FIGO stage IB). In period II, two premalignancies were found. None of the lesions would have been missed without standard endometrial sampling. No interval endometrial cancers were detected in this study.

Conclusion: In this study, annual endometrial screening seems an effective screening tool in the detection of premalignancies and early endometrial cancer in women with LS. Adding standard endometrial sampling to annual TVU has no additional value in the early detection of (pre)malignant endometrial lesions in women with LS in this study.

Keywords: Endometrial cancer; Gynecological screening; HNPCC; Lynch syndrome; Microcurettage; Premalignancy.

MeSH terms

  • Adult
  • Colorectal Neoplasms, Hereditary Nonpolyposis / diagnostic imaging
  • Colorectal Neoplasms, Hereditary Nonpolyposis / genetics
  • Colorectal Neoplasms, Hereditary Nonpolyposis / pathology*
  • Early Detection of Cancer / methods
  • Endometrial Neoplasms / diagnosis*
  • Endometrial Neoplasms / diagnostic imaging
  • Endometrial Neoplasms / genetics
  • Endometrial Neoplasms / pathology
  • Endometrium / pathology*
  • Family Health
  • Female
  • Humans
  • Middle Aged
  • Mutation
  • Precancerous Conditions / diagnosis*
  • Precancerous Conditions / diagnostic imaging
  • Precancerous Conditions / genetics
  • Precancerous Conditions / pathology
  • Ultrasonography