419 Cost-effectivness and the role of diagnostic tools for screening early stages of endometrial cancer

Objectives According to the World Cancer Research Fund, over 380,000 new cases of endometrial cancer have been reported in 2018. After the identification of disease, histologic diagnosis is the main standard for managing further treatment approaches. The following analysis is aimed to examine cost-effectiveness of two preoperative endometrial sampling methods - hysteroscopy and curettage; comparing tumor localization, grading and staging in patients with endometrial cancer. Methods The differences in the specifications of 64 patients that underwent hysteroscopy or curettage in tertiary care center in Croatia were tested. According to five different guidelines, all cases of endometrial cancer were classified into groups of low risk, intermediate, high-intermediate or high risk. Statistical test used for analysis were Kolmogorov-Smirnov test, T-test ant the Z-test. Given data of 36 women who underwent hysteroscopy and 28 women who underwent curettage were analysed. Results Occurrence rates of Grade 1 and Grade 2 of endometrial cancer were higher in patients who underwent hysteroscopy (p=0.03572, p=0.03846) (picture 1). According to the classification of risk factors, no differences in incidence were found between two groups (picture 2). Conclusions In Croatia, the cervical dilation and curettage is a less-frequently used method despite being 62% more affordable than the hysteroscopy, while on the other hand, there is statistically significant difference in preferred choice of the two methods given the histologic grade of cancer and age at the time of diagnosis.