Screening for endometrial hyperplasia and endometrial cancer in premenopausal women with polycystic ovary syndrome : a systematic review protocol
Rajalakshmi Rajendran, Marva Abdul Khader, Priya Shivanna, Prathiksha M Shet, Niyam Hegde, Deeya Karkera, Girish ThungaIntroduction
Endometrial hyperplasia (EH) is a condition that arises due to prolonged exposure of the endometrium to unopposed oestrogen, resulting in abnormal proliferation of endometrial tissue. Atypical hyperplasia, a subtype of EH, is considered a precursor lesion for endometrial cancer (EC). Polycystic ovary syndrome (PCOS) is a recognised risk factor for the development of EH and EC due to chronic anovulation and prolonged oestrogen exposure without progesterone opposition. Despite this increased risk, current clinical guidelines do not recommend routine screening for EH or EC among asymptomatic women with PCOS. The study aims to determine the effectiveness of screening for EH and EC in women with PCOS, particularly among premenopausal women, compared with no screening, reporting the occurrence and clinical outcomes of endometrial pathology among women with PCOS.
Methods and analysis
This systematic review will adhere to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive literature search will be conducted across multiple electronic databases from inception until February 2026. Two reviewers will independently perform study screening, data extraction and methodological quality assessment of the included studies. Discrepancies between reviewers will be resolved through discussion or consultation with a third reviewer. Extracted data will be summarised narratively, and where appropriate, quantitative synthesis will be performed using Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI). Heterogeneity among studies will be assessed, and subgroup and sensitivity analyses will be conducted when feasible.
Ethics and dissemination
Ethical approval is not required for this systematic review and meta-analysis, as it will use data from previously published studies. The results of the review will be published in academic journals and presented at international conferences.
PROSPERO registration number
CRD420251274598.