1538 Incidence of Gynecologic Cancers in Women after Uterine Fibroid Embolization

Abstract

Study Objective To estimate the likelihood that patients who have undergone uterine fibroid embolization (UFE) for leiomyomata will go on to develop subsequent gynecologic cancer that may have been prevented with hysterectomy. Design We identified women over 18 years old without prior diagnosis of cancer who had undergone UFE for treatment of leiomyomata in the MarketScan database between 2007 and 2016. Records were then electronically queried for any diagnostic or procedure codes (ICD9, ICD10, and CPT) related to uterine, cervical, tubal, or ovarian malignancies occurring after the UFE procedure date through the end of data available. All charts identified through electronic query had all codes manually reviewed by a minimum of three coders to confirm diagnosis of cancer, and discrepancies were resolved by consensus. Diagnosis of cancer was defined as having at least two codes for gynecological malignancy submitted at least one week apart and/or with malignancy codes linked to tissue pathology results. Descriptive statistics were generated for the final study sample. Setting N/A Patients or Participants Patient data was obtained from MarketScan, a database of diagnostic and treatment data for over 60 million commercially insured individuals in the US. Interventions N/A Measurements and Main Results Between 2007 and 2016, 20,575 women underwent UFE. Fifty-one women met criteria for exhibiting cancer after UFE (37/51, 73% uterine cancer; 13/51, 25% ovarian cancer; 1/51, 2% cervical cancer). One in 403 (95% CI: 1 in 354 to 1 in 469) women undergoing UFE developed a gynecologic malignancy. On average, women exhibited cancer within 2.3 years from the date of UFE with a standard deviation of ±2.14 years and a range of 17 days to 7.8 years. Conclusion A small fraction of women undergoing UFE develop subsequent gynecologic malignancies. Women choosing uterine preservation with UFE should be counseled about the risk of developing gynecologic malignancies in the future, some of which may be preventable with hysterectomy.