Abnormal Uterine Bleeding and Cancer of the Genital Tract

All patients in Tasmania admitted to hospital for investigation of abnormal uterine bleeding in 1987 and 1988 were studied. A total of 4,318 patients were investigated. Four of 539 (0.7%) patients with intermenstrual or postcoital bleeding and 31 of 538 (5.8%) patients with postmenopausal bleeding were found to have endometrial cancer. Of the 3,421 patients investigated for 'heavy' periods (menorrhagia) there was no case of endometrial cancer. The detection rate of endometrial cancer on dilatation and curettage before the menopause is extremely low. Patients presenting with menorrhagia should not be treated surgically in the first instance unless an obvious organic cause is present.