Awareness and care seeking pattern for symptoms associated with endometrial carcinoma among postmenopausal women in the district of Colombo: a cross-sectional study

Abstract

Introduction Variations in endometrial carcinoma awareness among postmenopausal women may explain the variations in care seeking pattern for symptoms associated with endometrial carcinoma. Objectives To describe the awareness and care seeking pattern for symptoms associated with endometrial carcinoma among postmenopausal women in the district of Colombo. Methods A community based descriptive cross sectional study was conducted among 1168 postmenopausal women in the district of Colombo, using multistage cluster sampling technique. A pre-tested interviewer administered questionnaire was used. Descriptive statistics were used to describe the awareness and care seeking pattern. Results Of the sample, 83.6% (95% CI: 81.5-85.7, n=977) had heard about endometrial carcinoma. About 56% of women (n=654) were aware that postmenopausal bleeding was a suggestive symptom of endometrial carcinoma. Only 24.0% (n=280) knew that never conceived was a risk factor, 20.6% and 20.9% knew that physical inactivity and obesity were risk factors respectively and 28.0% knew that hormone replacement therapy was a risk factor, for endometrial carcinoma. Of the women, 26.6% (n=311) had experienced some gynaecological symptoms similar to symptoms of endometrial carcinoma during their postmenopausal period. Majority of them had disclosed to the children (n=155, 49.8%) about the symptoms, 70.7% (n=220) had sought treatment, and the most common reason for seeking treatment was physical discomfort (n=83, 37.8%). A majority had gone to the government hospital (n=75, 34%) to get treatment.

Prevalence of being 'At Risk' of Endometrial Carcinoma among Postmenopausal Women in Sri Lanka

“…The country-specific risk prediction model used had been developed and validated by the authors, based on the risk factors of an unmatched case-control study conducted in the Western Province with the participation of 83 histologically confirmed incident endometrial carcinoma cases and 332 histologically excluded controls (20). The developed risk prediction model is valid to identify high risk women of developing endometrial carcinoma at the cut-off of 3.5 (range of score: 0-9); sensitivity 65.7% (95% CI=47.7-80.3); specificity 76.0% (95% CI=61.5-86.5) and area under the curve 0.778 (95% CI=0.679-0.877; p<0.001) (21). Table 1 shows the developed risk prediction model comprising six risk predictors and individual score to each predictor.…”

“…The prevalence of 'at risk' women for developing endometrial carcinoma was 19.2% (95% CI=17.0-21.6%). Since the current study used a validated risk prediction model and assessed the prevalence based on a validated cut-off determined through validation with a gold standard (histological assessment) (21), this prevalence value is considered to reflect the true prevalence of 'at risk' postmenopausal women for endometrial carcinoma among the study population. The prevalence of 'at risk' for endometrial carcinoma detected in the current study cannot be compared with the other studies as the risk predictors used in risk prediction models vary from one model to the other.…”