ObjectiveRisk stratification has resulted in patient-initiated follow-up being introduced for low-risk endometrial cancer in place of routine hospital follow-up. The financial benefit to the patient and the healthcare economy of patient-initiated follow-up, as compared with hospital follow-up, has yet to be explored. In this study, we explored the potential impact for both the healthcare economy and patients of patient-initiated follow-up.MethodsWomen diagnosed with low-risk endometrial cancer enrolled on a patient-initiated follow-up scheme between November 2014 and September 2018 were included. Data on the number of telephone calls to the nurse specialists and clinic appointments attended were collected prospectively. The number of clinic appointments that would have taken place if the patient had continued on hospital follow-up, rather than starting on patient-initiated follow-up, was calculated and costs determined using standard National Health Service (NHS) reference costs. The time/distance traveled by patients from their home address to the hospital clinic was calculated and used to determine patient-related costs.ResultsA total of 187 patients with a median of 37 (range 2–62) months follow-up after primary surgery were enrolled on the scheme. In total, the cohort were scheduled to attend 1673 appointments with hospital follow-up, whereas they only attended 69 clinic appointments and made 107 telephone contacts with patient-initiated follow-up. There was a 93.5% reduction in costs from a projected £194 068.00 for hospital follow-up to £12 676.33 for patient-initiated follow-up. The mean patient-related costs were reduced by 95.6% with patient-initiated follow-up. The total mileage traveled by patients for hospital follow-up was 30 891.4 miles, which was associated with a mean traveling time per patient of 7.41 hours and clinic/waiting time of 7.5 hours compared with 1165.8 miles and 0.46 hours and 0.5 hours, respectively, for patient-initiated follow-up.ConclusionThe introduction of a patient self-management follow-up scheme for low-risk endometrial cancer was associated with financial/time saving to both the patient and the healthcare economy as compared with hospital follow-up.

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Differences in patient demographic and tumour characteristics between patients of South Asian and White ethnicity diagnosed with an endometrial cancer (EC) and currently living in England are not well described. We undertook a retrospective study of EC cases diagnosed at the University Hospitals of Leicester, UK. A total of 1884 cases were included, with 13% of the patients being of South Asian ethnicity. South Asian women were diagnosed at a significantly younger age (mean age of 60.3 years) compared to women of White ethnicity (mean age of 66.9 years) with a mean difference of 6.6 years (95% CI 5.1 to 8.1, p < 0.001). Rising body mass index (BMI) in the White patient group was significantly correlated with younger age at diagnosis (p < 0.001); however, this association was not seen in South Asian patients. A linear regression that adjusted for diabetes status, BMI, and the interaction terms of diabetes status with BMI and ethnicity with BMI, highlighted a younger age of diagnosis in South Asian patients with a BMI less than 45 kg/m2. The difference was greatest at lower BMIs for both non-diabetics and diabetics. Further investigation is needed to explain these differences and to determine their impact on suspected cancer referral criteria.

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According to our findings, abnormal uterine bleeding is considered the guiding symptom for the diagnosis of this oncological pathology, being to one of the most frequent reasons to demand a gynecological evaluation.Endometrial polyps are the main observed lesions in our cohort, in both ultrasound exam and hysteroscopy.