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Suspected endometrial cancer — DRCOG MCQ

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HardGynaecological OncologySuspected endometrial cancerDRCOG

A 49-year-old woman with BMI 42 kg/m² has 4 months of irregular heavy bleeding between periods. She has type 2 diabetes and takes tamoxifen after breast cancer. Pregnancy test is negative. When should this patient be referred?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Urgent gynaecology assessment for endometrial pathology

Persistent intermenstrual bleeding with obesity, diabetes and tamoxifen exposure raises concern for endometrial hyperplasia or cancer and needs urgent gynaecology assessment. Perimenopause can cause irregular bleeding, but risk factors make reassurance unsafe. Cervical screening does not assess the endometrium. The pearl is that cancer risk stratification depends on bleeding pattern plus metabolic and medication risks.

Reference: NICE NG12; NICE NG88