P0064 Investigation of endometrial cancer and associated risk factors at Lagos University Teaching Hospital, Nigeria: A 5-year review

Abstract

Background Endometrial cancer is the most common gynaecological cancer in most developed countries. Although endometrial carcinoma is still the third commonest gynaecological malignancy in Nigeria, incidence is increasing. Endometrial cancer is most common among postmenopausal women and postmenopausal bleeding is the hallmark symptom. The main risk factors for the development of endometrial carcinoma are advanced age, menopause, and obesity. All women with suspected endometrial cancer require transvaginal ultrasonography and most will undergo endometrial biopsy; more sophisticated radiological examinations are required for accurate preoperative staging. We sought to determine the risk factors and clinical features of endometrial cancer in patients presenting between January, 2008, and December, 2012, at Lagos University Teaching Hospital. Methods This was a retrospective study done at Lagos University Teaching Hospital. All patients who had endometrial cancer during the trial period were identified and their case notes were retrieved from the medical records. Relevant data were obtained using a proforma. The data obtained were collated and analysed using simple tables and graphs. The identified risk factors, clinical features, and a diagnostic evaluation of women with endometrial cancer were compared with data published in the literature. Findings During the study period, the number of patients diagnosed with endometrial cancer was 61. However, only 44 (72%) whose case notes were retrieved were studied; 17 (28%) patients whose case folders were not found were excluded. Endometrial cancer was uncommon in young and premenopausal women as it was found in only one (2%) woman younger than 40 years. The malignancy occurred in 25 (41%) women of middle age (41–60 years) and in 35 (57%) older women (> 60 years). Of the women diagnosed, eight (18%) were premenopausal and 36 (82%) were postmenopausal. The predominant complaint was postmenopausal vaginal bleeding, which was reported by all the women. The most common risk factors were old age, overweight, and obesity. The most common subtype was the endometrioid type. Interpretation The major risk factors for endometrial cancer in this hospital setting in Nigeria include advanced age, menopause, overweight, and obesity. While findings in ultrasonography could be suggestive of the disease, endometrial biopsy is diagnostic.