Significance of Atrophy on Endometrial Sampling in Women Younger than Fifty Years of Age

Most women (90%) with endometrial cancer develop symptomatic vaginal bleeding or discharge, and this is often what prompts them to seek gynecologic care [1]. The American College of Obstetricians and Gynecologists (ACOG) recommends endometrial tissue sampling in any woman with abnormal uterine bleeding who is older than 45 years, or in younger patients who have failed medical management, have persistent abnormal uterine bleeding, or have unopposed estrogen exposure, such as in obesity or polycystic ovary syndrome [2]. There is currently a large body of evidence to guide gynecologists in the treatment of women found to have endometrial hyperplasia or cancer on biopsy or curettage [3-5]. However, there is little to no evidence to guide clinicians in the interpretation of non-hyperplastic, nonneoplastic endometrial sampling findings, which may result in delayed diagnosis in those patients with a false negative result.