الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Abnormal uterine bleeding is a common but complicated clinical presentation. It accounts for up to 70% of all gynaecological consultations in the peri- and post-menopausal years. The underlying pathology varies between different groups of women. However, there is a range of benign focal lesions, such as fibroids and polyps, that may be responsible for it, and evaluation of the uterine cavity is usually required, particularly if irregular blood loss is reported. In groups of women at risk of endometrial cancer, endometrial biopsy is one of the mainstays of clinical investigation, and is usually combined with ‘visualisation’ by means of hysteroscopy or ultrasound scan.
Endometrial carcinoma is the most common malignancy of the female genital tract. It is predominantly a disease of postmenopausal women, most cases occurring in the sixth and seventh decades, with less than 5% of cases in women under 40 years of age. The lifetime risk of developing endometrial cancer is 1.1% while the lifetime risk of dying of endometrial cancer is 0.4%, reflecting the good prognosis of the condition with early diagnosis. Unlike other malignancies, endometrial cancer often presents at an early stage when there is a possibility of curative treatment by hysterectomy. Survival decreases with increased staging and lower histological differentiation, thus accurate and timely diagnosis is important and should preferably be carried out by a safe, simple and minimally invasive method. Also its most frequent subtype, endometrioid carcinoma (“type I” cancers), is often preceded by a histologically evident precursor lesion. Accurate and sensitive recognition of these precursors, which generally have fallen under the diagnostic umbrella of “hyperplasias” has great clinical value as an early warning of heightened cancer risk and a potential target for preventative treatment.