{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T14:35:55Z","timestamp":1784039755846,"version":"3.55.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T00:00:00Z","timestamp":1649721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002739","name":"Aarhus Universitets Forskningsfond","doi-asserted-by":"publisher","award":["120.000"],"award-info":[{"award-number":["120.000"]}],"id":[{"id":"10.13039\/501100002739","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009584","name":"Toyota Foundation","doi-asserted-by":"publisher","award":["150.000"],"award-info":[{"award-number":["150.000"]}],"id":[{"id":"10.13039\/100009584","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018732","name":"Vissing Foundation","doi-asserted-by":"crossref","award":["185.000"],"award-info":[{"award-number":["185.000"]}],"id":[{"id":"10.13039\/100018732","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100006197","name":"Fonden til L\u00e6gevidenskabens Fremme","doi-asserted-by":"publisher","award":["10.000"],"award-info":[{"award-number":["10.000"]}],"id":[{"id":"10.13039\/501100006197","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006308","name":"Helga og Peter Kornings Fond","doi-asserted-by":"publisher","award":["8000"],"award-info":[{"award-number":["8000"]}],"id":[{"id":"10.13039\/501100006308","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Simons Spies Fonden","award":["15.000"],"award-info":[{"award-number":["15.000"]}]},{"name":"The Research Fund, Randers Regional Hospital","award":["20.000"],"award-info":[{"award-number":["20.000"]}]},{"name":"Holms Mindelegat","award":["55.000"],"award-info":[{"award-number":["55.000"]}]},{"DOI":"10.13039\/501100008208","name":"Overl\u00e6ge Johan Boserup og Lise Boserups Legat","doi-asserted-by":"crossref","award":["80.000"],"award-info":[{"award-number":["80.000"]}],"id":[{"id":"10.13039\/501100008208","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Fonden af 1870","award":["7000"],"award-info":[{"award-number":["7000"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>The strong association between atypical endometrial hyperplasia and endometrial carcinoma is well established, but data on the risk of atypical hyperplasia and carcinoma in Danish women with non-atypical endometrial hyperplasia are almost non-existent. This study aimed to investigate the prevalence of atypical hyperplasia and endometrial carcinoma diagnosed within 3 months of initial diagnosis (defined as concurrent disease) and the risk of atypical hyperplasia and carcinoma more than 3 months after initial diagnosis (classified as progressive disease) in Danish women initially diagnosed with non-atypical endometrial hyperplasia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Design<\/jats:title>\n<jats:p>This cohort study recruited 102 women diagnosed with non-atypical endometrial hyperplasia at Randers Regional Hospital in Randers, Denmark, between 2000 and 2015.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The endometrium was evaluated by transvaginal ultrasound examination and office mini-hysteroscopy with biopsies in all non-hysterectomized women. Data regarding subsequent hysterectomy or endometrial sampling were obtained from medical records and the Danish Pathology Registry (Patobank).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 15 women were diagnosed with atypical hyperplasia or carcinoma during follow-up. Concurrent atypical hyperplasia or carcinoma was seen in 2.9% (3\/102), and among women who remained at risk for more than 3 months after initial diagnosis of non-atypical endometrial hyperplasia (<jats:italic>n<\/jats:italic> = 94), progression to atypical hyperplasia or carcinoma was seen in 13% (median follow-up 5.2 years, range 3.6 months to 15.1 years). Sixty-six percent of the women with progressive disease were diagnosed with atypical hyperplasia or carcinoma more than 1 year after initial diagnosis, but only two were diagnosed later than 5 years (5.2 and 9 years).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The risk of being diagnosed with atypical endometrial hyperplasia or endometrial carcinoma more than 5 years after an initial diagnosis of non-atypical endometrial hyperplasia seems to be low in Danish women. Specialized follow-up more than 5 years after diagnosis of non-atypical endometrial hyperplasia may not be warranted.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0266339","type":"journal-article","created":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T17:44:30Z","timestamp":1649785470000},"page":"e0266339","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Risk of atypical hyperplasia and endometrial carcinoma after initial diagnosis of non-atypical endometrial hyperplasia: A long-term follow-up study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4607-035X","authenticated-orcid":true,"given":"Clara M.","family":"Prip","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Stentebjerg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary H.","family":"Bennetsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lone K.","family":"Petersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinar","family":"Bor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,4,12]]},"reference":[{"issue":"3","key":"pone.0266339.ref001","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"H Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"pone.0266339.ref002","volume-title":"WHO classification of tumours of female reproductive organs","author":"RJ Kurman","year":"2014"},{"issue":"5","key":"pone.0266339.ref003","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1200\/JCO.2009.24.1315","article-title":"Absolute risk of endometrial carcinoma during 20-year follow-up among women with endometrial hyperplasia","volume":"28","author":"JV Lacey","year":"2010","journal-title":"J Clin Oncol"},{"issue":"11","key":"pone.0266339.ref004","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1097\/PAS.0b013e31825dd4ff","article-title":"Clinical outcome of atypical endometrial hyperplasia diagnosed on an endometrial biopsy: institutional experience and review of literature","volume":"36","author":"E Rakha","year":"2012","journal-title":"Am J Surg Pathol"},{"issue":"4","key":"pone.0266339.ref005","doi-asserted-by":"crossref","first-page":"e0232231","DOI":"10.1371\/journal.pone.0232231","article-title":"Concurrent and future risk of endometrial cancer in women with endometrial hyperplasia: A systematic review and meta-analysis","volume":"15","author":"MT Doherty","year":"2020","journal-title":"PLoS One"},{"issue":"11","key":"pone.0266339.ref006","doi-asserted-by":"crossref","first-page":"2304","DOI":"10.1002\/cncr.21058","article-title":"The molecular genetics and morphometry-based endometrial intraepithelial neoplasia classification system predicts disease progression in endometrial hyperplasia more accurately than the 1994 World Health Organization classification system","volume":"103","author":"JP Baak","year":"2005","journal-title":"Cancer"},{"issue":"2","key":"pone.0266339.ref007","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1136\/ijgc-00009577-200403000-00023","article-title":"Risk of progression in complex and atypical endometrial hyperplasia: clinicopathologic analysis in cases with and without progestogen treatment","volume":"14","author":"LC Horn","year":"2004","journal-title":"Int J Gynecol Cancer"},{"issue":"4","key":"pone.0266339.ref008","doi-asserted-by":"crossref","first-page":"357.e1","DOI":"10.1016\/j.ajog.2010.12.007","article-title":"Molecular biomarkers in endometrial hyperplasias predict cancer progression","volume":"204","author":"A Steinbakk","year":"2011","journal-title":"Am J Obstet Gynecol"},{"issue":"2","key":"pone.0266339.ref009","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s004040000151","article-title":"Natural history of endometrial hyperplasia. 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