Prediction models in women with postmenopausal bleeding: A systematic review

Nehalennia Van Hanegem*, Maria C. Breijer, Brent C. Opmeer, Ben W.J. Mol, Anne Timmermans

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

9 Citations (Scopus)


Postmenopausal bleeding is associated with an elevated risk of having endometrial cancer. The aim of this review is to give an overview of existing prediction models on endometrial cancer in women with postmenopausal bleeding. In a systematic search of the literature, we identified nine prognostic studies, of which we assessed the quality, the different phases of development and their performance. From these data, we identified the most important predictor variables. None of the detected models completed external validation or impact analysis. Models including power Doppler showed best performance in internal validation, but Doppler in general gynecological practice is not easily accessible. We can conclude that we have indications that the first step in the approach of women with postmenopausal bleeding should be to distinguish between women with low risk versus high risk of having endometrial carcinoma and the next step would be to refer patients for further (invasive) testing.

Original languageEnglish
Pages (from-to)251-262
Number of pages12
JournalWomen's Health
Issue number3
Publication statusPublished - May 2012


  • endometrial carcinoma
  • multivariate analysis
  • postmenopausal bleeding
  • prediction models
  • prognostic studies


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