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EV365/#839  Trends in the incidence of endometrial hyperplasia from 2008 to 2020 in a UK population
  1. Haydee Jordão1,
  2. Helen Coleman1,
  3. Chris Cardwell1,
  4. Glenn Mccluggage2,
  5. James Wylie3,
  6. Declan Quinn3,
  7. Anna Gavin4,
  8. Damien Bennett4 and
  9. Úna Mcmenamin1
  1. 1Queen’s University Belfast, Centre for Public Health, Belfast, UK
  2. 2Belfast Health and Social Care Trust, Department of Pathology, Belfast, UK
  3. 3Northern Health and Social Care Trust, Department of Obstetrics and Gynaecology, Antrim, UK
  4. 4Northern Ireland Cancer Registry, Belfast, UK

Abstract

Introduction Endometrial cancer incidence is increasing in the UK, but it is unclear whether this is due to an increase in endometrial hyperplasia (EH), the precursor lesion of many endometrioid carcinomas. We aimed to investigate, for the first time, trends in EH diagnosis rates over a 13-year period in a UK population.

Methods The Northern Ireland (NI) Endometrial Hyperplasia Register (NIEHR) contains all EH diagnoses in NI between 2008-2020. European age-standardised annual EH incidence rates were calculated per 100,000, and per 100 endometrial samples. Linkage to the NI Cancer Registry identified concurrent endometrial cancers (within three months before or after EH diagnosis).

Results A total of 2,808 women were diagnosed with EH: 1,857 (66%) with EH without atypia and 943 (34%) with atypical EH. Overall, EH incidence rates reduced by 28.5%, reducing from 37.5/100,000 during 2008–2011 to 26.8/100,000 during 2016–2019, which was similar by EH type (table 1, and figure 1). A further reduction in EH diagnoses was observed in 2020 (17.0/100,000), likely due to the COVID-19 pandemic. The reduction in incidence was more marked than corresponding reductions in endometrial sampling rates (18.8% reduction in EH incidence/100 samplings). The prevalence of concurrent endometrial cancer was 8.6%; and was much higher in atypical EH (21.7%) than EH without atypia (1.8%).

Conclusion/Implications We observed a reduction in the incidence of EH over time, which cannot be fully explained by reductions in endometrial sampling. However, this may also reflect evolving trends in EH diagnosis with the advent of greater pathological subspecialisation.

Abstract EV365/#839 Table 1

Average annual endometrial hyperplasia incidence rates in Northern Ireland

Abstract EV365/#839 Figure 1

European age-standardised incidence of endometrial hyperplasia (EH) in Northern Ireland from 2008 to 2020

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