Patients’ preferences in the evaluation of postmenopausal bleeding
Article first published online: 6 JUL 2007
RCOG 2007 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 114, Issue 9, pages 1146–1149, September 2007
How to Cite
Timmermans, A., Opmeer, B., Veersema, S. and Mol, B. (2007), Patients’ preferences in the evaluation of postmenopausal bleeding. BJOG: An International Journal of Obstetrics & Gynaecology, 114: 1146–1149. doi: 10.1111/j.1471-0528.2007.01424.x
- Issue published online: 6 JUL 2007
- Article first published online: 6 JUL 2007
- Accepted 15 May 2007. Published OnlineEarly 6 July 2007.
- patients’ preferences;
- postmenopausal bleeding
Objective To assess patients’ preferences for diagnostic management of postmenopausal bleeding (PMB).
Design A structured interview.
Setting A teaching hospital with office hysteroscopy facilities.
Population Thirty-nine women with PMB and with a completed work-up including an office hysteroscopy.
Methods A structured interview was taken from 39 women who had had an office hysteroscopy in the diagnostic work-up for PMB. Women were informed about the probability of endometrial carcinoma versus benign disease and about advantages and disadvantages of different diagnostic strategies, i.e. expectant management after ultrasound or complete diagnostic work-up, including invasive procedures.
Main outcome measures Women were informed about the probability of endometrial carcinoma versus benign disease and about advantages and disadvantages of different diagnostic strategies, i.e., expectant management after ultrasound or complete diagnostic work-up including invasive procedures. Women were asked to make a trade-off between different options.
Results Most women wanted to be 100% certain that carcinoma could be ruled out. Only 5% of the women were willing to accept more than 5% risk of false reassurance. If the risk of recurrent bleeding due to benign disease exceeded 25%, the majority of women would prefer immediate diagnosis and treatment of benign lesions.
Conclusion Women with PMB are prepared to undergo hysteroscopy to rule out any risk on cancer. This finding implicates that the measurement of endometrial thickness with transvaginal ultrasound as a first-line test in the assessment of PMB should be reconsidered.