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Endometriosis-affected patients face a 4.2-fold raised risk of ovarian cancer, with a 9.7-fold higher risk in those suffering from ovarian endometriomas and deep infiltrating endometriosis.
According to the findings of a study, women diagnosed with endometriosis, particularly those with more severe forms of the condition, face a much higher risk of developing ovarian cancer. This population could therefore be a critical group for targeted ovarian cancer screening and prevention efforts. The study, which analyzed data from the Utah Population Database, included 78,893 endometriosis-affected women matched to 5 women without the condition.
The goal was to investigate the link between endometriosis subtypes and the likelihood of ovarian cancer, focusing on both the overall risk and the specific ovarian cancer histotypes. In this population-based cohort study, endometriosis cases were meticulously identified using electronic health records and categorized into distinct subtypes: superficial endometriosis, ovarian endometriomas, deep infiltrating endometriosis (DIE), and others.
The study's primary outcomes included calculating adjusted hazard ratios (aHRs) and adjusted risk differences (aRDs) per 10,000 females, along with 95% confidence intervals. This was done to determine the chances of overall ovarian cancer, as well as type I (clear cell, endometrioid, low-grade serous, and mucinous) and type II (high-grade serous) ovarian cancers. These findings were derived from comparisons between women with each endometriosis subtype and those without the condition.
Rigorous statistical models accounted for key variables such as sociodemographic factors, reproductive history, and previous gynecologic surgeries, ensuring a robust analysis of cancer risk.
Endometriosis-affected women exhibited a markedly higher risk of developing ovarian cancer when compared to those without the condition (aHR, 4.20; aRD, 9.90). The chances of type I ovarian cancer were particularly heightened (aHR, 7.48; aRD, 7.53).
The highest ovarian cancer risk was observed in those suffering from DIE and/or ovarian endometriomas, with a marked escalation in risk for all ovarian malignancies (aHR, 9.66; aRD, 26.71), type I ovarian malignancies (aHR, 18.96; aRD, 19.57), and even type II ovarian malignancies (aHR, 3.72; aRD, 2.42). Thus, while all forms of endometriosis are linked to an increased risk, the most severe forms, particularly ovarian endometriomas and DIE, are associated with the highest risk of both type I and type II ovarian cancers. The study highlights the need for patient counseling to inform women battling endometriosis—especially those with more severe forms—about their increased cancer risk and the potential advantages of early detection strategies.
JAMA
Endometriosis Typology and Ovarian Cancer Risk
Mollie E. Barnard et al.
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