Risk factors for endometrial cancer in women presenting with postmenopausal bleeding

Background: Postmenopausal bleeding (PMB) is a significant clinical symptom to consider in detail due to its potential link with endometrial carcinoma, the most common cause of cancer-related mortality in women. While PMB can be caused by benign pathology such as endometrial atrophy, it is essential to recognize those who are at risk of malignancy. Risk factors including age, obesity, diabetes, late menopause, and endometrial thickness are of utmost significance for the identification of women at higher risk for endometrial cancer. Objective: The aim of this study is to explore the risk indicators of endometrial cancer among women presenting with postmenopausal bleeding, with a view to assisting practitioners in early detection and treatment. Method: A hospital-based observational study was conducted in BIRDEM General Hospital (Women & Children), Dhaka, Bangladesh. during the timeline of January 2024 to December 2024. Postmenopausal women aged 45 years and more who had reported PMB were recruited into the study. Clinical assessment, transvaginal sonography (TVS), and histopathological examination were performed to determine the etiology of the bleeding. Demographic, clinical, and reproductive histories were elicited and data gathered, and statistical analysis was performed using SPSS. Results: Among 68 cases, 27.3% were diagnosed with endometrial carcinoma. There were significant associations between endometrial cancer and advanced age (?60 years), obesity, diabetes, late menopause, and endometrial thickness >10 mm. Multivariate logistic regression analysis indicated obesity (adjusted OR 3.21), diabetes (adjusted OR 2.94), and endometrial thickness >10 mm (adjusted OR 5.67) as independent risk factors for endometrial cancer. Conclusion: Risk variables for endometrial cancer in women presenting with postmenopausal bleeding include nulliparity, late menopause, thickened endometrium, diabetes, and obesity. Early identification of the high-risk women by selective diagnostic testing through transvaginal sonography and biopsy is crucial to improve outcomes. More extensive population-based studies are needed to confirm these findings and define more precise clinical strategies to the management of PMB.