| Abnormal uterine bleeding |
- Postmenopausal patients – Any uterine bleeding, regardless of volume (including spotting or staining). Pelvic ultrasound to evaluate endometrial thickness is an alternative to endometrial sampling in appropriately selected patients. A thickened endometrium should be further evaluated with endometrial sampling.
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- Age 45 years to menopause – In any patient, bleeding that is frequent (interval between the onset of bleeding episodes is <21 days), heavy, or prolonged (>8 days). In patients who are ovulatory, this includes intermenstrual bleeding.
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- Younger than 45 years – Any abnormal uterine bleeding in patients with BMI ≥30 kg/m2. In patients with BMI <30 kg/m2, abnormal uterine bleeding that is persistent and occurs in the setting of one of the following: chronic ovulatory dysfunction, other exposure to estrogen unopposed by progesterone, failed medical management of the bleeding, or patients at high risk of endometrial cancer (eg, Lynch syndrome, Cowden syndrome).
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- In addition, endometrial neoplasia should be suspected in premenopausal patients who are anovulatory and have prolonged periods of amenorrhea (six or more months).
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| Cervical cytology results |
- Presence of AGC-endometrial.
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- Presence of AGC-all subcategories other than endometrial – If ≥35 years of age or at risk for endometrial cancer (risk factors or symptoms).
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- Presence of benign-appearing endometrial cells in patients ≥40 years of age who also have abnormal uterine bleeding or risk factors for endometrial cancer.
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| Other indications |
- Monitoring of patients with endometrial pathology (eg, endometrial hyperplasia).
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- Screening in patients at high risk of endometrial cancer (eg, Lynch syndrome).
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