Risks of Malignancy among 11,204 Patients with Endometrial Polyp: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
Abstract Objectives: To evaluate factors associated with malignancy in patients with endometrial polyps. Materials and Methods: We conducted electronic database research on PubMed, MEDLINE, EMBASE, COCHRANE, and Google Scholar from inception for all studies on endometrial polyp. After removing duplicates, and title and abstract screening, we had a total of 121 articles and 151 others from screening the reference list. Inclusion criteria included peri and postmenopausal women > 45 years diagnosed histopathologically with endometrial polyp(s). We excluded women with a history of endometrial cancer or hysterectomy. Results: Twenty studies were analyzed. Of 11204 patients with endometrial polyp, 287 had malignant polyps (2.75%), 182 (1.8%) had concomitant endometrial hyperplasia with atypia, and 520 (5.2%) had hyperplasia without atypia within the polyp. Menopausal women had a higher risk of pre-malignancy/malignancy than non-menopausal women (OR 5.63 (95CI 3.87, 8.20, I 2 = 0%, P < 0.001). Endometrial thickness on ultrasound in pre-malignancy/malignancy cases was significantly thicker than in the benign polyp (mean difference 4.2 mm, 95% CI 0.8 to 7.6 mm, I 2 = 18%, P = 0.02). Women who used tamoxifen or hormone replacement therapy (HRT) had a lower likelihood of endometrial pre-malignancy/malignancy, while women with abnormal uterine bleeding (AUB) had a higher probability of pre-malignancy/malignancy. The odd ratio of having pre-malignancy/malignancy among those who used tamoxifen was 0.50 (95% CI 0.26-0.94: I 2 12%, p = 0.03). Conclusion: In women with endometrial polyp, menopausal age and thickened endometrium might increase the probability while tamoxifen or HRT use might lower the likelihood of endometrial pre-malignancy/malignancy; and the presence of AUB might signal endometrial pre-malignancy/malignancy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.011 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".