Awareness of Endometrial Cancer Risk and Compliance With Screening in Hereditary Nonpolyposis Colorectal Cancer

Ketabi, Zohreh MD; Mosgaard, Berit J. MD, PhD; Gerdes, Anne-Marie MD, PhD; Ladelund, Steen; Bernstein, Inge T. MD, PhD

Obstetrics & Gynecology:
doi: http://10.1097/AOG.0b013e31826ba2aa
Original Research

OBJECTIVE: Women with hereditary nonpolyposis colorectal cancer (HNPCC) have a 40–60% lifetime risk for endometrial cancer. Guidelines in Denmark recommend gynecologic screening for female members of families with HNPCC. We estimated the knowledge of endometrial cancer risk and identified possible predictors of compliance with the screening among women from families with HNPCC.

METHODS: A questionnaire exploring the knowledge of endometrial cancer risk and compliance with screening was sent to 707 women from families with HNPCC who had been recommended endometrial cancer surveillance. The response rate after one reminder was 86% (606 of 707). Data were analyzed by simple and multivariable logistic regression models.

RESULTS: Four hundred seventy-one women were included in the final analyses; 65% reported being aware of the increased risk of endometrial cancer. The awareness was significantly greater among women with high educational level (81%; P<.001), women who had received genetic counseling (75%; P<.001), women with family history of gynecologic cancer (76%; P<.001), and those with high perceived endometrial cancer risk (77%; P<.001). Overall, 67% had participated in gynecologic screening. No significant differences were found in compliance regarding women's educational level or their family risk classification. Analyses of data in a multivariable logistic regression model showed that knowledge of endometrial cancer risk was the most important predictor for positive compliance with the gynecologic screening (odds ratio 4.86, 95% confidence interval 3.05–7.74).

CONCLUSION: Women's awareness of endometrial cancer risk is the most important predictor of their compliance with gynecologic screening in families with HNPCC.


Author Information

The Danish HNPCC-register, Department of Surgical Gastroenterology and Department of Clinical Research Centre, Copenhagen University Hospital, Hvidovre, the Department of Obstetrics and Gynecology, Copenhagen University Hospital, Herlev, and the Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, Denmark.

Corresponding author: Zohreh Ketabi, HNPCC-register, Clinical Research Centre 136, Hvidovre Hospital, Kettegård Allé 30, DK 2650, Hvidovre, Denmark; e-mail:

Supported by a grant from the Danish Cancer Society (grant number: A20-A822–10-S2) and the Aase and Ejnar Danielsen's Foundation.

The authors thank the women who participated in this study and the clinical genetic departments for recruiting families to the national database.

Presented as an oral presentation at the InSiGHT meeting, March 31–April 2, 2011, San Antonio, Texas, and at the Danish Gynecologic Cancer Group's annual meeting, October 11, 2011, Vejle, Denmark.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2012 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.