The DOI matches its Crossref record; 184 of the 217 references it cites were found in a registry or an index; 4 of the 26 sources its claims cite were checked for support.
Association of Endometrial Cancer Risk With Postmenopausal Bleeding in Women
Open accessAbstract
Importance: As the worldwide burden of endometrial cancer continues to rise, interest is growing in the evaluation of early detection and prevention strategies among women at increased risk. Focusing efforts on women with postmenopausal bleeding (PMB), a common symptom of endometrial cancer, may be a useful strategy; however, PMB is not specific for endometrial cancer and is often caused by benign conditions. Objective: To provide a reference of the prevalence of PMB in endometrial cancers and the risk of endometrial cancer in women with PMB. Data Sources: For this systematic review and meta-analysis, PubMed and Embase were searched for English-language studies published January 1, 1977, through January 31, 2017. Study Selection: Observational studies reporting the prevalence of PMB in women with endometrial cancer and the risk of endometrial cancer in women with PMB in unselected populations were selected. Data Extraction and Synthesis: Two independent reviewers evaluated study quality and risk of bias using items from the Newcastle-Ottawa Quality Assessment Scale and the Quality Assessment of Diagnostic Accuracy Studies tool. Studies that included highly selected populations, lacked detailed inclusion criteria, and/or included 25 or fewer women were excluded. Main Outcomes and Measures: The pooled prevalence of PMB in women with endometrial cancer and the risk of endometrial cancer in women with PMB. Results: A total of 129 unique studies, including 34 432 unique patients with PMB and 6358 with endometrial cancer (40 790 women), were analyzed. The pooled prevalence of PMB among women with endometrial cancer was 91% (95% CI, 87%-93%), irrespective of tumor stage. The pooled risk of endometrial cancer among women with PMB was 9% (95% CI, 8%-11%), with estimates varying by use of hormone therapy (range, 7% [95% CI, 6%-9%] to 12% [95% CI, 9%-15%]; P < .001 for heterogeneity) and geographic region (range, 5% [95% CI, 3%-11%] in North America to 13% [95% CI, 9%-19%] in Western Europe; P = .09 for heterogeneity). Conclusions and Relevance: Early detection strategies focused on women with PMB have the potential to capture as many as 90% of endometrial cancers; however, most women with PMB will not be diagnosed with endometrial cancer. These results can aid in the assessment of the potential clinical value of new early detection markers and clinical management strategies for endometrial cancer and will help to inform clinical and epidemiologic risk prediction models to support decision making.
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Claims the paper makes
12 Own result · 7 Own interpretation · 6 No full text of the sources · 4 Own method · 2 Partly supported · 2 Not checked yet · 2 No basis given · 1 Supported so far · accuracy not yet measured
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and geographic region (range, 5% [95% CI, 3%-11%] in North America to 13% [95% CI, 9%-19%] in Western Europe; P = .09 for heterogeneity).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Oursystematicreviewandmeta-analysisdemonstrates that PMB is very sensitive for endometrial cancer detection,occurringinapproximately90%ofcases.”
- Also stated in: § Strengths and Limitations · p. 8 · hedged
“Our results suggest that approximately10%ofwomendiagnosedwithendometrialcancer donotpresentwithPMB.”
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Strengths and Limitations · p. 8 · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The pooled risk of endometrial cancer among women with PMB was 9% (95% CI, 8%-11%), with estimates varying by use of hormone therapy”
- Also stated in: § Risk of Endometrial Cancer in Women With PMB · p. 3 · plain
“yielding an overall pooled estimate of 9% (95% CI, 8%-11%), with moderate variability observed between studies (τ 2 = 0.56).”
plaincorrelationaln = 432- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Risk of Endometrial Cancer in Women With PMB · p. 3 · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, our results suggested a lower prevalence of endometrial cancer in retrospective and prospective cohort studiescomparedwithcross-sectionalstudies.”
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Ourmeta-analysisconfirmsa lower risk of endometrial cancer among women with PMB and polyps.”
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“TheriskofendometrialcanceramongwomenwithPMBwas notablylowerinstudiesthatincludedHTuserscomparedwith those that excluded these women.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The pooled prevalence of PMB among women with endometrial cancer was 91% (95% CI, 87%-93%), irrespective of tumor stage.”
plaincorrelationaln = 790- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“among women with PMB, only approximately9%willbediagnosedwithendometrialcancer”
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Evidence of publication bias suggested that small studies may overestimate the risk of endometrial cancer in women with PMB (Egger regression intercept, 0.75; P = .001).”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Certaincombinedformulationsof estrogenplusprogestintherapyareestablishedtohaveaprotective effect on the endometrium. 163”
What the sources say
- Not checked — no full text of the sourcecites [163] source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 14
- It may state two separate claims as one. 15
- The quote only partly states this claim. 1
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Currentpracticeguidelines recommend workup to rule out endometrial cancer among all womenwithPMB.”
What the sources say
- Not checked — no full text of the sourcecites [18] source
- Supportedcites [19] source
The Introduction states that guidelines addressing postmenopausal bleeding aim to exclude endometrial carcinoma or precancerous lesions. The Abstract likewise says that diagnostic workup for patients with postmenopausal bleeding is aimed at excluding malignancy. (LLM, conf=0.90)
- Not checked — no full text of the sourcecites [166] source
- Not checked — no full text of the sourcecites [167] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In the United States, guidelines recommend TVUSorendometrialbiopsyasthefirststepinevaluatingPMB. 19”
What the sources say
- Partly supportedcites [19] sourceExperimental — accuracy not yet measured
The Abstract says transvaginal sonography is used as a first step in evaluating postmenopausal bleeding. Section 2.2 describes guidelines advocating endometrial sampling after ultrasound shows increased endometrial thickness, not biopsy as an alternative first step. The paper does not identify these as United States guidelines. (LLM, conf=0.87)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Interest has increased in the use of biomarkers, such as DNA methylation, to i mprove early detection of endometrial cancer. 31,32,170,171”
What the sources say
- Supportedcites [31] source
The Introduction says a growing number of methylated genes have been identified in endometrial cancer and describes methylation assays as promising for detection. The Discussion explicitly describes work to develop a clinically useful early-detection assay and ongoing discovery of methylation biomarkers. The supplied passages do not provide page numbers. (LLM, conf=0.91)
- Partly supportedcites [32] sourceExperimental — accuracy not yet measured
The Methylation Specific PCR section (page not provided) describes testing MLH1 methylation in tumor samples, and the Abstract discusses molecular markers for classifying high-risk endometrial cancers. The paper addresses prognosis and treatment decisions, not growing interest in DNA methylation biomarkers for early detection. (LLM, conf=0.82)
- Not checked — no full text of the sourcecites [170] source
- Not matchedcites [171]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“TheprevalenceofPMBinendometrialcancerandtheriskof endometrialcancerinwomenwithPMBwerehigherbefore2000 comparedwithafter2000.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Atotal of 129 unique studies, including 34 432 unique patients with PMB and 6358 with endometrial cancer (40 790 women), were analyzed.”
plainn = 6,358- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Inthesubsetofstudiesincludedinour meta-analysis that included women with PMB and a minimum endometrialthickness,thepooledriskofendometrialcancerwas 19%,morethandoubletheriskobservedinourmainanalysis.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“with estimates varying by use of hormone therapy (range, 7% [95% CI, 6%-9%] to 12% [95% CI, 9%-15%]; P < .001 for heterogeneity)”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“magnitude of the increase in PPV of both tests with increasing risk of endometrial cancer in women with PMB, supporting the evaluation of early-detection strategies in various populations.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Wenotedstrikinggeographicdifferencesinendometrialcancer risk among women with PMB, ranging from 13% in Western Europe to 5% in North America and 7% in Northern Europe.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The widespread practice of referring all women with PMB for TVUS and/or endometrial biopsy carries a considerable burden and cost.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“we excluded studies that included special populations (eg, defined by comorbid conditions or specific histologic findings), lacked detailed inclusion criteria, and/or included 25 or fewer women.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As new markers are discovered or new clinical management strategies are evaluated, our results can aid in the assessment of their potential clinical value and will help to inform clinical and epidemiologic risk prediction models to support clinical decision making.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“With respect to the analysis of the risk of endometrialcancerinwomenwithPMB,moststudieswerecrosssectional,andfewincludedprospectivefollow-up;thus,wewere unabletoevaluatelong-termriskofendometrialcancerinthese studies.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Ourfindingssupportthisrecommendationby providingreassurancethattargetingthishigh-riskgroupofwomenforearlydetectionandpreventionstrategieswillcapturemost endometrialcancers.”
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“However, PMB is often associated with benign conditions such as endometrial polyps or may result from unscheduled bleeding in women using hormone therapy (HT). 18,21”
What the sources say
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These results can aid in the assessment of the potential clinical value of new early detection markers and clinical management strategies for endometrial cancer and will help to inform clinical and epidemiologic risk prediction models to support decision making.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
- Rests on an assumption: No recommendation for population-based screening for endometrial cancer currently exists.
- Rests on an assumption: Studies evaluating early detection strategies for endometrial cancer are lacking.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our findings can support risk-informed decision making in clinical management of women with PMB.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In general,dataonstudy-levelvariablessuchasyearssincemenopause andbodymassindexwereinconsistentlyreported,limitingour abilitytoevaluatethem.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Postmenopausal bleeding (PMB) is a common symptom of endometrial cancer and accounts for approximately two-thirds of all gynecologic visits among perimenopausal and postmenopausal women. 18”
What the sources say
- Not checked — no full text of the sourcecites [18] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“InmanyEuropeancountries,guidelinesrecommendTVUS asthefirst-linetest,withhistologicassessmentindicatedforwomenwithathickenedendometriumbasedoncutoffsrangingfrom 3 to 5 mm. 18,166,167”
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Ourdataemphasizetheimportanceofconsideringawoman'sHTstatustoinformclinicaldecisionmaking, potentially supporting a less aggressive management approach in HT users.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“TheunderlyingcausesofHT-induced bleedingisthoughttoinvolvechangesinthesizeofendometrial bloodvesselsandregulationofvasculargrowthandintegrity. 165”
What the sources say
- Not checked — no full text of the sourcecites [165] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Ourstudyrepresents an important and timely evaluation of the risk of endometrial cancer in women with PMB and can serve as a reliable reference for the prevalence of PMB in women with endometrial cancer and the risk of endometrial cancer in women with PMB”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: unclear — It is unclear whether it could be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
No recommendation for population-based screening for endometrial cancer currently exists.
“However, studies evaluating early detection strategies for endometrial cancer are lacking, and at present no recommendation for population-based screening exists.”
The paper relies on this without support.
Studies evaluating early detection strategies for endometrial cancer are lacking.
“However, studies evaluating early detection strategies for endometrial cancer are lacking, and at present no recommendation for population-based screening exists.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Risk of Endometrial Cancer in Women With PMB · p. 4
“comparedwiththe51studiesthatincludedwomen using HT 21,23,25-27,78-81,83-88,90,91,95-97,100,107-111,113,114,117,119, 122-126,128-131,134,135,139,142,148,151,153-157,159”
§ Results · p. 3
“and92 22-27,58,78-162 wereincludedforanalysisof theriskofendometrialcancerinwomenwithPMB(31220womenwithPMBand2611casesofendometrialcancer).”
Citations
Cites
Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012
Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D. M., Forman, D., & Bray, F. (2015) · International Journal of Cancer · doi:10.1002/ijc.29210 · Cited by 28,766
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164
Self-citationDermyshi, E., Wang, Y., Yan, C., Hong, W., Qiu, G., Gong, X., & Zhang, T. (2017) · Neonatology · doi:10.1159/000454668 · Cited by 24,586
Siegel, R. L., Miller, K. D., & Jemal, A. (2017) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21387 · Cited by 14,712
QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies
Whiting, P. F., Rutjes, A. W. S., Westwood, M. E., Mallett, S., Deeks, J. J., Reitsma, J. B., Leeflang, M. M. G., Sterne, J. A. C., Bossuyt, P. M. M., & the QUADAS-2 Group* (2011) · Annals of Internal Medicine · doi:10.7326/0003-4819-155-8-201110180-00009 · Cited by 14,199
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.06.006 · Cited by 10,578
Self-citationA Re-Evaluation of Random-Effects Meta-Analysis
Higgins, J. P. T., Thompson, S. G., & Spiegelhalter, D. J. (2009) · Journal of the Royal Statistical Society Series A: Statistics in Society · doi:10.1111/j.1467-985x.2008.00552.x · Cited by 2,569
Metaprop: a Stata command to perform meta-analysis of binomial data
Nyaga, V. N., Arbyn, M., & Aerts, M. (2014) · Archives of Public Health · doi:10.1186/2049-3258-72-39 · Cited by 2,139
Self-citationPalandri, F., Breccia, M., Bonifacio, M., Polverelli, N., Elli, E. M., Benevolo, G., Tiribelli, M., Abruzzese, E., Iurlo, A., Heidel, F. H., et al. (2006) · Cancer · doi:10.1002/(issn)1097-0142 · Cited by 1,477
Global cancer in women: burden and trends.
Torre, L. A., Islami, F., Siegel, R. L., Ward, E. M., & Jemal, A. (2017) · Cancer Epidemiology, Biomarkers & Prevention · doi:10.1158/1055-9965.epi-16-0858 · Cited by 1,245
Research works printed but not linked: 1
- Emanuel, 1995, An audit of true prevalence of intra-uterine pathology: the hysteroscopical findings controlled for patient selection in 1202 patients with abnormal uterine bleeding., Gynaecol Endosc, 4, 237
Cited by
Sorted by citations
Items 401–421 of 421
Karmous, N., Jemli, H., Masmoudi, A., Bouguerra, B., Mabrouk, A., Dhaou, A. B., & Karmous, A. (2026) · F1000Research · doi:10.12688/f1000research.170227.2
Orellana, M. A., Williams, P. A., Alson, J., et al. (2026) · Journal of Participatory Research Methods · doi:10.35844/001c.162280
Liu, J., C.Nolin, A., Unnithan, S., et al. (2026) · Gynecologic Oncology Reports · doi:10.1016/j.gore.2026.102135
Chen, X. J., Liu, L., Jin, X., Cheng, Y., Wu, H. C., You, Y., Liou, Y., Liu, P., Lang, J., & Li, L. (2026) · Frontiers in Oncology · doi:10.3389/fonc.2026.1849730
Defining low-risk group before surgical treatment in endometrial cancer: A retrospective review
Kaban, A., Kinter, A. K., Öcal, E. U. B., et al. (2026) · Medicine · doi:10.1097/md.0000000000049188
Clarke, M. A., & Wijayabahu, A. T. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-45863-7.00071-8
Self-citationYen, T., Lu, C. A., Hsieh, T. Y. J., Lee, G. Y., Jiang, C., & Tanner, E. J. (2026) · Gynecologic Oncology · doi:10.1016/j.ygyno.2026.06.023
#Jump4June: an opportunity to revisit the evaluation of post-menopausal bleeding
Leis, L. V., Shinkado, Y. R., Santos, R. A. M., et al. (2026) · International Journal of Gynecological Cancer · doi:10.1016/j.ijgc.2026.104853
Diagnosis and Treatment of Cancers Specific to Pelvic and Women’s Health
Özgül, N., & Akgör, U. (2026) · Springer eBooks · doi:10.1007/978-3-032-28741-0_13
Protein signatures for the early detection of endometrial cancer in cervico-vaginal fluid
Njoku, K., Dore, M., Johnson, J.-E., Davies, J. C., Pierce, A., Chiasserini, D., Choudhury, A., Whetton, A. D., Unwin, R. D., & Crosbie, E. J. (2026) · Expert Review of Molecular Diagnostics · doi:10.1080/14737159.2026.2705465
Xu, M., Xu, W., Lu, Z. Y., et al. (2026) · Frontiers in Oncology · doi:10.3389/fonc.2026.1818266
Advances in urinary biomarkers for endometrial cancer detection
Dore, M., Cao, J., Baker-Rand, H. L. A., Choudhury, A., Whetton, A. D., Unwin, R. D., Crosbie, E. J., & Njoku, K. (2026) · British Journal of Cancer · doi:10.1038/s41416-026-03579-8
Li, L., Yang, D., Zhai, Y., Yu, Z., Wang, Y., Shi, X., Li, X., Li, H., & Ge, H. (2026) · Frontiers in Oncology · doi:10.3389/fonc.2026.1914063
Long, J. L., Agrusa, S., Pukhrambam, S., et al. (2026) · iScience · doi:10.1016/j.isci.2026.117226
Postmenopausal bleeding associated with semaglutide: a diagnostic challenge
Prasad, S., Parmar, V., Sharma, A., Kaur, N., Kothia, D., & Bavaria, D. (2026) · JCEM Case Reports · doi:10.1210/jcemcr/luag261
Harrington, S. P., Taheri, N., Salinas, M., et al. (2026) · Gynecologic Oncology Reports · doi:10.1016/j.gore.2026.102214
Self-citationShrestha, R., Bang, B., & Beqaj, S. (2026) · Gynecologic Oncology Reports · doi:10.1016/j.gore.2026.102221
Ma, J., Li, L., Hu, R., et al. (2026) · Journal of Genetic Engineering and Biotechnology · doi:10.1016/j.jgeb.2026.100817
Karacabey, S., Atas, B. S., Gungor, E., & Pehlivan, K. S. (2026) · Diagnostics · doi:10.3390/diagnostics16193219
Arellano-Oleas, Y. E., Toro-Bautista, D. M., & Peñaherrera-Ron, M. T. (2026) · Sanitas. Revista arbitrada de ciencias de la salud. · doi:10.62574/jtws9v81
Yaniv, R. T., Tzur, T., Goldstein, H., et al. (2026) · Cancers · doi:10.3390/cancers18193206
Metadata
- Authors
- Clarke, M. A., Long, B. J., Del Mar Morillo, A., Arbyn, M., Bakkum-Gamez, J. N., & Wentzensen, N.
- Affiliations
- Division of Cancer Epidemiology and Genetics (US)
- Mayo Clinic (US)
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
- Sciensano (Belgium) (BE)
- Corresponding author
- Clarke, Megan A.
- Venue
- JAMA Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2018-09-01
- Volume
- 178
- Issue
- 9
- Pages
- 1210
- ISSN
- 2168-6106 (ISSN-L)
- PMC
- PMC6142981
- OpenAlex
- W2885550086
- Cited by
- 426
- References
- 217
- Citations by year
- 2026: 61 · 2025: 65 · 2024: 66 · 2023: 65 · 2022: 66 · 2021: 54 · 2020: 32 · 2019: 15 · 2018: 1
- FWCI
- 4.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Internal Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- endometrial cancer, postmenopausal bleeding, cancer risk, prevalence, hormone therapy, early detection, cancer screening, tumor stage, regional variation, risk factors, women's health, cancer prevention, risk stratification, screening eligibility, risk communication, shared decision-making, quality of life, quality of life after cancer treatment
- MeSH terms
- Biopsy, Female, Humans, Risk Factors, Uterine Hemorrhage, Global Health, Prevalence, Endometrial Neoplasms, Postmenopause
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-30, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-09-30 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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