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Endometrial and Cervical Cancer Treatments · Journal article
Diagnostics · September 2, 2026
Reinforces what was already believed, rather than introducing something new.
This retrospective cohort of 2588 Polish women undergoing outpatient hysteroscopic polypectomy reports endometrial carcinoma in 0.62% (16 patients) and pre-malignant lesions in 15.26%, confirming that malignancy is rare but present and strongly associated with age, postmenopausal status, obesity, and hypertension. The study reinforces the importance of systematic histopathological examination despite low visual malignancy risk.
Retrospective cohort study. Patients treated at the Outpatient Hysteroscopy Center of Heliodor Swiecicki University Hospital of Gynecology and Obstetrics, affiliated with Poznan University of Medical Sciences, undergoing hysteroscopic polypectomy under local anesthesia.. Intervention: Hysteroscopic polypectomy using GUBBINI mini-resectoscope under local anesthesia with Hystero-Block system, followed by histopathological examination of resected polyp specimens.. n = 2,588. Single center: Outpatient Hysteroscopy Center, Heliodor Swiecicki University Hospital of Gynecology and Obstetrics, Poznan University of Medical Sciences, Poland..
Endometrial carcinoma identified in 16 of 2588 patients (0.62%) Glandular hyperplasia without atypia in 360 patients (13.91%); atypical hyperplasia in 35 patients (1.35%) Postmenopausal status associated with endometrial carcinoma: OR 6.56 (95% CI 2.12–20.30, p=0.001)
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Clinicians should maintain a low threshold for histopathological examination of all resected endometrial polyps despite the low overall malignancy rate (0.62%), particularly in older, postmenopausal, obese, or hypertensive patients where concurrent premalignancy or carcinoma risk is substantially elevated. Visual inspection alone is inadequate for exclusion of malignancy.
A large retrospective cohort confirming the low but clinically important prevalence of endometrial carcinoma in endometrial polyps (0.62%) and identifying established demographic and metabolic risk factors, with clear statistical analysis but observational design and no intervention.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should maintain a low threshold for histopathological examination of all resected endometrial polyps despite the low overall malignancy rate (0.62%), particularly in older, postmenopausal, obese, or hypertensive patients where concurrent premalignancy or carcinoma risk is substantially elevated. Visual inspection alone is inadequate for exclusion of malignancy.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background/Objectives: Endometrial polyps are a prevalent pathological condition within the uterine cavity. While the majority of lesions are classified as benign, histopathological examinations indicate a potential for malignant transformation occurring in 0.5–5% of cases. The present study aimed to evaluate the prevalence of endometrial carcinoma and pre-malignant histopathological findings (glandular hyperplasia without atypia and atypical glandular hyperplasia) associated with endometrial polyps and to identify pertinent risk factors among Polish women undergoing hysteroscopic polypectomy under local anesthesia. Methods: A retrospective cohort study was conducted at the Outpatient Hysteroscopy Center of the Heliodor Swiecicki University Hospital of Gynecology and Obstetrics, affiliated with Poznan University of Medical Sciences. The study included patients treated using the GUBBINI mini-resectoscope under local anesthesia with the Hystero-Block system (Tontarra Medizintechnik GmbH, Wurmlingen, Germany) between December 2022 and July 2026. Statistical analysis of risk factors was performed using the Kruskal–Wallis H test and Fisher’s exact test. Odds ratios for potential risk factors were also calculated. Results: The study comprised 2588 patients. Endometrial carcinoma associated with endometrial polyps was identified in 16 women (0.62%). Additional histopathological findings included glandular hyperplasia in 360 patients (13.91%) and atypical hyperplasia in 35 patients (1.35%), with the remaining patients diagnosed with benign uterine polyps (84.12%). Patients with malignant and pre-malignant lesions were significantly older than those with benign polyps (p < 0.001). Regarding polyp size, patients diagnosed with glandular hyperplasia without atypia had significantly larger polyps than those with benign lesions (p < 0.001). Estimated postmenopausal status was associated with significantly higher odds of endometrial carcinoma (Odds Ratio [OR] = 6.56, 95% Confidence Interval [CI]: 2.12–20.30, p = 0.001) and atypical glandular hyperplasia (OR = 3.13, 95% CI: 1.41–6.96, p = 0.005) compared to benign polyps. Similarly, obesity increased the odds of glandular hyperplasia without atypia (OR = 1.32, 95% CI: 1.01–1.74, p = 0.045) and atypical glandular hyperplasia (OR = 3.33, 95% CI: 1.67–6.65, p < 0.001). Furthermore, hypertension was associated with higher odds of glandular hyperplasia without atypia compared to benign polyps (OR = 1.41, 95% CI: 1.02–1.97, p = 0.040). Other evaluated risk factors, including type II diabetes mellitus, infertility, abnormal uterine bleeding, breast cancer history, hypothyroidism and polyendocrine metabolic ovarian syndrome (PMOS), did not reach statistical significance (p > 0.05). This large cohort provides important data regarding the prevalence and risk factors of carcinoma associated with endometrial polyps and pre-malignant uterine lesions in Polish women. Conclusions: Endometrial carcinoma associated with endometrial polyps is a rare entity among Polish women undergoing outpatient hysteroscopy (0.62%). Nevertheless, the primary diagnostic value of this large-scale study lies in demonstrating that despite the low prevalence of malignancy in standard “see-and-treat” outpatient settings, systematic histopathological evaluation remains an absolute diagnostic mandate, as relying solely on visual or clinical parameters is insufficient to exclude malignancy. Furthermore, identified risk factors, such as age, polyp size, estimated postmenopausal status, obesity and hypertension, serve as critical diagnostic red flags, associated with increased odds of concurrent premalignant lesions or carcinoma.
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