Endometrial polyps: Symptomatology, menopausal status and malignancy

Aims: To assess the frequency of premalignant and malignant endometrial polyps in symptomatic and asymptomatic women. Methods: Retrospective registration of 1,124 patients who underwent hysteroscopic resection of endometrial polyps. Patient characteristics included age, menopausal status, presence or absence of symptoms, and use of hormonal medication. Histological diagnoses and complications were also analyzed. Results: 641 (57%) of 1,124 women with endometrial polyps were postmenopausal and 483 (43%) premenopausal. Abnormal uterine bleeding was reported by 548 women: 226 (49%) postmenopausal and 322 (51%) premenopausal. 576 (51%) women were asymptomatic. There were 16 patients with malignancy or premalignant conditions among the symptomatic patients (2.7%) compared to 7 such patients among the asymptomatic patients (1.3%; p = 0.17). Pathologic evaluation disclosed 7 cases of malignancy and 4 cases of atypical hyperplasia among bleeding postmenopausal women (11/263, 4%) and 2 malignancies and 3 cases of hyperplasia with atypia among asymptomatic postmenopausal women (5/378, 1.3%). Conclusion: We found premalignancy and malignancy in each patient group - pre- and postmenopausal, as well as symptomatic and asymptomatic. We recommend removal of any verified endometrial polyp.