alexa Risk Factors (Excluding Hormone Replacement Therapy) for Endometrial Hyperplasia: a Systematic Review
ISSN: 2161-1165

Epidemiology: Open Access
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Review Article

Risk Factors (Excluding Hormone Replacement Therapy) for Endometrial Hyperplasia: a Systematic Review

Omolara B Sanni1*, Andrew T Kunzmann1, Liam J Murray1, W Glenn McCluggage2 and Helen G Coleman1

1Cancer Epidemiology & Health Services Research Group, Centre for Public Health, Queen’s University Belfast, Northern Ireland

2Department of Pathology, Belfast Health and Social Care Trust, Northern Ireland

Corresponding Author:
Omolara Sanni
Centre for Public Health, Institute of Clinical Sciences, Block B
Queen’s University Belfast, Royal Victoria Hospital
Grosvenor Road, Belfast, Northern Ireland
Tel: 009 44 7476101022
E-mail: [email protected]

Received Date: February 15, 2016; Accepted Date: March 04, 2016; Published Date: March 11, 2016

Citation: Sanni OB, Kunzmann AT, Murray LJ, McCluggage WG, Coleman HG (2016) Risk Factors (Excluding Hormone Replacement Therapy) for Endometrial Hyperplasia: A Systematic Review. Epidemiol 6:229. doi:10.4172/2161-1165.1000229

Copyright: © 2016 Sanni OB et al., This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Objective: To conduct a systematic review of risk factors associated with the development of Endometrial Hyperplasia (EH).

Data sources: Ovid MEDLINE, EMBASE and Web of Science databases were searched from inception to 30 June 2015.

Study eligibility: Fifteen observational studies that reported on EH risk in relation to lifestyle factors (n=14), medical history (n=11), reproductive and menstrual history (n=9) and measures of socio-economic status (n=2) were identified. Pooled relative risk estimates and corresponding 95% confidence intervals (CI) were able to be derived for EH and Body Mass Index (BMI), smoking, diabetes and hypertension, using random effects models comparing high versus low categories.

Results: The pooled relative risk for EH when comparing women with the highest versus lowest BMI was 1.82 (95% CI 1.22–2.71; n=7 studies, I2=90.4%). No significant associations were observed for EH risk for smokers compared with non-smokers (RR 0.88, 95% CI 0.66-1.17; n=3, I2=0.0%), hypertensive versus normotensive women (RR 1.51, 95% CI 0.72–3.15; n=5 studies, I2=79.1%), or diabetic versus non-diabetic women (RR 1.77, 95% CI 0.79–3.96; n=5 studies, I2=31.8%) respectively although the number of included studies was limited. There were mixed reports on the relationship between age and risk of EH. Too few studies reported on other factors to reach any conclusions in relation to EH risk.

Conclusions: A high BMI was associated with an increased risk of EH, providing additional rationale for women to maintain a normal body weight. No significant associations were detected for other factors and EH risk, however relatively few studies have been conducted and few of the available studies adequately adjusted for relevant confounders. Therefore, further aetiological studies of endometrial hyperplasia are warranted.


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