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Endometrial cancer risk — DRCOG MCQ

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HardGynaecological OncologyEndometrial cancer riskDRCOG

A 49-year-old woman with BMI 41 and PCOS has 5 months of unpredictable heavy bleeding. Pregnancy test is negative and haemoglobin is 104 g/L. She has never had cervical screening. What is the most appropriate investigation?

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Correct answer: A — Endometrial sampling through a gynaecology pathway

Obesity, PCOS and abnormal bleeding increase risk of endometrial hyperplasia or cancer, so endometrial assessment is needed. Cervical screening is important but does not investigate the endometrium. The pearl is that unopposed oestrogen risk factors lower the threshold for endometrial sampling.

Reference: NICE NG88; NICE NG12