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Endometrial pathology in bariatric surgery candidates from three institutions

Ju, Jinghui (2019) Endometrial pathology in bariatric surgery candidates from three institutions. Master Essay, University of Pittsburgh.

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Background: Obesity has been shown to have public health impact on increasing risk for pre-malignant and malignant changes in the endometrium. However, little is known about the prevalence of endometrial pathology in women with severe obesity, a population that may be less likely to obtain gynecologic care.
Methods: This study was designed to describe the prevalence of endometrial pathologies in women with severe obesity undergoing bariatric surgery, and to compare it with the prevalence of endometrial pathologies in the general population. We collected histologic and demographic data from three US cohorts of women with severe obesity, who were asymptomatic for gynecologic conditions, and had no history of endometrial cancer. Endometrial samples were obtained by Pipelle aspiration before or during bariatric surgeries. Logistic regression was used to assess the relationship between body mass index (BMI) and endometrial anomalies (hyperplasia, metaplasia and polyp) and proliferative endometrium. A systematic literature search of endometrial pathology in the general population was performed using PubMed to extract prevalence data.
Results: Among 104 women who had sufficient endometrial biopsies for diagnosis from three cohort studies, the median of age and BMI of the sample were 38.0 years and 45.9 kg/m2, respectively. Endometrial biopsy results were: proliferative (44.2%), secretory (24.0%), inactive (17.3%), hyperplasia (8.7%), and metaplasia or endometrial polyp (5.8%). After adjusting for age and race, an increase in BMI by 1 kg/m2 was associated with 11% greater odds of having endometrial anomalies or proliferative endometrium (p < 0.01). Our sample appeared to have higher prevalence of anomalies excluding polyps (10.6%), hyperplasia (8.7%) and proliferative endometrium (44.2%) compared to the general population from published studies (anomalies excluding polyps: 0.8% to 7.3%, pooled hyperplasia prevalence: 4.1%, pooled proliferative endometrium prevalence: 18.1%).
Conclusion: Among this sample of female bariatric surgery candidates, higher BMI was related to greater odds of endometrial pathologies or proliferative endometrium. Furthermore, endometrial pathologies appeared to be more common compared to the general population. More thorough examination of the relationships between levels of obesity and endometrial pathology are needed to better characterize high cancer risk groups who may benefit from introducing screening or preventive measures.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairLinkov, Fainalinkfy@upmc.eduUNSPECIFIEDUNSPECIFIED
Committee MemberKing, Wendykingw@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberRindos, Noahrindosnb@upmc.eduUNSPECIFIEDUNSPECIFIED
Date: 10 April 2019
Date Type: Submission
Number of Pages: 36
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 04 Oct 2019 22:40
Last Modified: 01 May 2021 05:15


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