Epplein et al. Respond to 'Endometrial Hyperplasia桮etting Back to Normal

摘要

We thank Dr. Lacey for his commentary (1). We share Dr. Lacey's concern that the inability to fully distinguish endometrial hyperplasia from carcinoma means that even if these conditions did not share risk factors, there would be some indication in a given study that they did. As he noted, we attempted to guard against this possibility by including as cases only those deemed by a pathology review panel to truly have hyperplasia (2). In addition, we redid our analyses after excluding those women initially diagnosed with hyperplasia who went on to have a diagnosis of endometrial cancer at hysterectomy performed within 8 weeks of the hyperplasia diagnosis (2). (Had we excluded women diagnosed as having hyperplasia who went on to be diagnosed with endometrial cancer later than this, we would have been studying the form of hyperplasia that tends not to progress. This was not our goal.)#