Incidence of Gynecologic Cancers in Women after Uterine Artery Embolization

Abstract

Study Objective: To characterize the short-term incidence of gynecologic cancer after undergoing uterine artery embolization (UAE). Design: Retrospective cohort study. Setting: Commercial insurance claims database. Patients: Total of 15 393 United States women aged 18 to 64 years who underwent UAE between 2007 and 2017.Interventions: We used the IBM MarketScan (Armonk, NY) claims to identify adult women without previous gynecologic cancer diagnoses undergoing UAE between 2007 and 2017. Database queries identified women with any diagnostic or procedure codes related to gynecologic malignancies occurring in the first 3 years after UAE. A malignancy diagnosis was suggested by recurrent malignancy-related claims not linked exclusively to diagnostic testing (e.g., transvaginal ultrasound) and malignancy codes linked to tissue pathology claims. Incidence of malignancy diagnosis was calculated. Rates of endometrial sampling in the year before UAE were identified. Measurements and Main Results: Thirty-one women undergoing UAE had gynecologic cancer diagnoses within 3 years of the procedure (22 of 31, 71% uterine cancers; 7 of 31, 23% ovarian cancers; and 2 of 31, 6% cervical cancers). On average, cancer diagnoses were made 1.1 § 0.9 years after UAE. One in 497 women undergoing UAE was diagnosed with a gynecologic malignancy within 3 years, with an incidence of 1.1 malignancies per 1000 person-years. Cancer incidence increased with age at the time of UAE: short-term malignancy diagnoses were made in 1 in 377 women aged 45 to 54 years, and 1 in 79 women aged 55 to 64 years. In the year before UAE, 28% (4311 of 15 362) of women without cancer, and 23% (5 of 22) of women diagnosed with uterine cancer had preprocedural endometrial sampling. Conclusion: These data can inform risk/benefit counseling and shared decision-making regarding UAE and its alternatives. Short-term malignancies after UAE highlight the importance of preprocedure evaluation in symptomatic women and women with age-related risk.

An update on uterine artery embolization for uterine leiomyomata and adenomyosis of the uterus

“…Based on a recent A recent retrospective cohort study, who investigated the incidence of gynecologic cancers in adult females who had undergone UAE for fibroids between 2007 and 2017, the authors found that one in 497 women undergoing UAE was diagnosed with a gynecologic malignancy within 3 years after treatment and concluded that short-term malignancies after UAE highlight the importance of pre-procedure evaluation in symptomatic females and females with age-related risk. 45 Neither size, number, location, or type of fibroid represent a true contraindication of the procedure. [46][47][48][49] However, given the wide variations in the extent of fibroid disease, ranging from a single huge leiomyoma, numerous fibroids and those with a distinct anatomical location such as a pedunculated cervical fibroid, every case should be addressed individually.…”

“…Based on a recent A recent retrospective cohort study, who investigated the incidence of gynecologic cancers in adult females who had undergone UAE for fibroids between 2007 and 2017, the authors found that one in 497 women undergoing UAE was diagnosed with a gynecologic malignancy within 3 years after treatment and concluded that short-term malignancies after UAE highlight the importance of pre-procedure evaluation in symptomatic females and females with age-related risk. 45 …”

Care Delivery for Patients with Leiomyomas: Failures, Real-Life Experiences, Analysis of Barriers, and Proposed Restorative Remedies

“… 90 Studies have estimated gynecologic cancer incidence after UFE to be 1 in 497 women in 3 years, which varied based on age. 46 , 88 , 89 , 91 …”