The risk of premalignant and malignant pathology in endometrial polyps

Objective. To evaluate the risk of premalignant and malignant pathology among endometrial polyps. Design. Prospective cohort study. Setting. Minimal Access Surgical Training (MAST) center in a large teaching hospital. Methods. Among 248 patients seen in outpatient hysteroscopy clinic (1996-97), 62 had endometrial polyps. All patients had endometrial sampling for histological assessment. To determine the magnitude of malignant potential among polyps, we compared the pathological findings in polyps (cases) with non-polypoidal specimens (controls). Results. Out of 62 polyps, histologically 53 (85.5%) were benign, seven (11.3%) had hyperplasia, and two (3.2%) were associated with malignancy. Hyperplasia was more frequent in endometrial specimens with polyps than in those without (11.3% vs 4.3%, p=0.04), but the incidence of carcinoma in the two groups was the same (3.2% ps 3.2%, p=1.0). Conclusion. In abnormal uterine bleeding, hyperplasia was, but cancer was not, more common in women with endometrial polyps compared to those without polyps.