Browsing by Author "Jayawickrama, W.I.U."

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Development of risk prediction model for endometrial carcinoma among postmenopausal women in the Western Province.
(Sri Lanka Medical Association., 2019) Jayawickrama, W.I.U.; Abeysena, H.T.C.S.
INTRODUCTION & OBJECTIVES: Risk prediction model can be used to estimate the probability of developing endometrial carcinoma among postmenopausal women. The aim of the study was to develop a model to predict the risk of endometrial carcinoma among postmenopausal women. METHODS: A case control study was conducted. The cases and the controls were defined as postmenopausal women who had and had not been diagnosed as endometrial carcinoma based on histological confirmation respectively. Variable selection was done considering the objectivity and feasibility of the measurements in addition to the statistical criteria. A scoring system [ 1-9) was designed based on weighted score of each risk predictor. Predictive validity of the model was tested by calibration and discrimination. Receiver Operator Characteristic (ROC) curve was used to determine the cut-off value. RESULTS: The developed model consisted of six predictors: Age >55 years, never conceived, age at menarche ≤11 years, ever experienced postmenopausal bleeding, having family history of any type of cancer among first degree relative, generalized obesity. Discrimination of the model was measured by the area under the ROC curve (0.92, 95% Confidence Interval: 0.88-0.95). Calibration with goodness of fit by Hosmer and Lemeshow test (p=0.72) was satisfactory. The tool demonstrated a good predictive ability with sensitivity of 89.2% (Cl: 79.9%-94.6%) and specificity of 76.2% (CI: 79.8%-80.3%) at the cut-off point of 3.5. CONCLUSION: Model demonstrated good discrimination and calibration. It can be used in screening of high risk women for developing endometrial carcinoma in the community.
Prevalence of being 'At Risk' of endometrial carcinoma among postmenopausal women in Sri Lanka
(College of Community Physicians of Sri Lanka, 2021) Jayawickrama, W.I.U.; Abeysena, C.
INTRODUCTION: Identifying women who are at risk of developing endometrial carcinoma helps to personalize the management strategies by increasing the survival of high-risk women. OBJECTIVES: To estimate the 'at risk' prevalence and prevalence of selected risk factors for endometrial carcinoma among postmenopausal women in the district of Colombo METHODS: A community-based descriptive cross-sectional study was conducted among 1168 postmenopausal women selected using multistage cluster sampling technique. Women who are 'at risk' for developing endometrial carcinoma was decided based on a cut-off value developed for the set of predictors related to the risk of developing endometrial carcinoma among postmenopausal women. RESULTS: The prevalence of at risk of endometrial carcinoma was 19.2% (95% CI=17.0-21.6). The prevalence of selected risk factors: physical inactivity 86.2% (95% CI=84.1-88.1), hypertension 37.8% (95% CI=35.1-40.7), diabetes mellitus 39.9% (95% CI=37.1-42.8), early menarche 12.1% (95% CI=10.3-14.1), late menopause 5.7% (95% CI=4.5-7.2), never conceived 7.8% (95% CI=6.3-9.5), generalized obesity 48% (95% CI=45.1-50.9), central obesity 58.6% (95% CI=55.8-61.5), and inadequate servings of vegetables and fruits 69.4% (95% CI=66.8-72.0). CONCLUSIONS & RECOMMENDATIONS: The identification of 'at risk' women who need to be investigated or followed up closely for endometrial carcinoma and the observed high prevalence of selected modifiable risk factors among postmenopausal women warrant population level interventions to curb unhealthy lifestyle practices and advocate relevant stakeholders for prompt action since childhood as a primary prevention measure. KEYWORDS: Endometrial carcinoma, Women at risk, Increased risk, Risk factor prevalence