No.	Recommendation	GoR	LoE	Sources
4.7	The risk of premenopausal women with abnormal uterine bleeding developing endometrial cancer or atypical endometrial hyperplasia is below 1.5%.	ST	2	64
4.8	In women with premenopausal abnormal uterine bleeding who do not have any risk factors (suspicious cytology, obesity, Lynch syndrome, diabetes, polyps, etc.), an attempt at conservative treatment should initially be made, provided that the bleeding is not hemodynamically relevant. If conservative therapy fails, hysteroscopy/curettage should be carried out.	EC
4.9	Hysteroscopy combined with fractional curettage is the gold standard for obtaining a reliable diagnosis of endometrial cancer.	ST	3	65 ,  66 ,  67
4.10	In a number of small series of symptomatic patients, diagnostic procedures such as pipelle sampling and Tao brush cytology offered positive and negative predictive values for diagnosing endometrial cancer which were comparable to those obtained with curettage plus hysteroscopy. However, larger comparative studies are still lacking.	ST	3	68
4.10.1	These diagnostic procedures are not at present comprehensively available on a quality-assured basis throughout Germany.	EC