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Polycystic ovary syndrome (PCOS) with persistent anovulation and resulting chronic unoppo...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDRF-REPRODUCTIVE-PCOS-ENDOMETRIAL-PREVENTION
TypeRed flag
Statusreviewed 2026-05-19 | pending_clinical_signoff
DiseasesDIS-ENDOMETRIAL
SourcesSRC-ESGO-ENDOMETRIAL-2025 SRC-ESMO-ENDOMETRIAL-2022 SRC-NCCN-BREAST-2025

Red Flag Origin

DefinitionPolycystic ovary syndrome (PCOS) with persistent anovulation and resulting chronic unopposed estrogen exposure on endometrial epithelium — endometrial cancer RR ~2.7 (Haoula et al. Hum Reprod Update 2012); earlier age of onset (40s vs typical 60s) common. Often accompanied by obesity + insulin resistance + type-2 diabetes — additional independent endometrial-cancer risk factors that compound risk multiplicatively. Endometrioid (type I) histology predominates. Frequently underrecognized in women relying on hormonal contraception that masks anovulation. Risk modifiable: combined hormonal contraception (estrogen + progestin) OR cyclic progestin OR levonorgestrel IUD restore endometrial protection. Weight loss + metformin (in T2DM/IR PCOS) provide additional risk reduction. Prevention-persona RedFlag (§20 v0.3 reproductive expansion).
Clinical directioninvestigate
Categoryother

Trigger Logic

{
  "any_of": [
    {
      "finding": "pcos_rotterdam_criteria_met",
      "value": true
    },
    {
      "finding": "pcos_with_anovulation_documented",
      "value": true
    },
    {
      "finding": "pcos_with_obesity_or_t2dm",
      "value": true
    },
    {
      "finding": "persistent_anovulation_or_pcos",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

Prevention-persona RedFlag for PCOS-anovulation endometrial risk. Separated from the broad reproductive RF for clearer routing — PCOS- specific counseling (progestin restoration, metformin, weight loss) is distinct from generic reproductive-history counseling. Symptom-driven endometrial biopsy in any abnormal bleeding ≥6 months of amenorrhea pre-menopausal OR any post-menopausal bleeding. STUB pending two-Co- Lead signoff per CHARTER §6.1 dev-mode.

Used By

Indications