Endometriosis as a risk factor for ovarian or endometrial cancer — results of a hospital-based case–control study

Abstract

BackgroundNo screening programs are available for ovarian or endometrial cancer. One reason for this is the low incidence of the conditions, resulting in low positive predictive values for tests, which are not very specific. One way of addressing this problem might be to use risk factors to define subpopulations with a higher incidence. The aim of this study was to investigate the extent to which a medical history of endometriosis can serve as a risk factor for ovarian or endometrial cancer.MethodsIn a hospital-based case–control analysis, the cases represented patients with endometrial or ovarian cancer who were participating in studies aimed at assessing the risk for these diseases. The controls were women between the age of 40 and 85 who were invited to take part via a newspaper advertisement. A total of 289 cases and 1016 controls were included. Using logistic regression models, it was tested whether self-reported endometriosis is a predictor of case–control status in addition to age, body mass index (BMI), number of pregnancies and previous oral contraceptive (OC) use.ResultsEndometriosis was reported in 2.1 % of the controls (n = 21) and 4.8 % of the cases (n = 14). Endometriosis was a relevant predictor for case–control status in addition to other predictive factors (OR 2.63; 95 % CI, 1.28 to 5.41).ConclusionThis case–control study found that self-reported endometriosis may be a risk factor for endometrial or ovarian cancer in women between 40 and 85 years. There have been very few studies addressing this issue, and incorporating it into a clinical prediction model would require a more precise characterization of the risk factor of endometriosis.

Cancer Implications for Patients with Endometriosis

“…75,76 Several studies have reported an association between endometriosis and endometrial cancer. 50,62,77 Endometriosis and endometrial cancer have overlapping risk factors, including increased levels of circulating estrogen and ovulatory dysfunction affecting proliferation of endometrial tissues both in and outside of the uterine cavity. Upon review of the cohort studies reported, however, statistical control for confounding variables appears to be an important factor in the reported associations between endometriosis and endometrial cancer.…”

Distribution of malignant neoplasms among patients with endometriosis: an epidemiological study

“…Взаимосвязь эндометриоза и рака тела матки не была подтверждена в большинстве крупных исследований [10,11,26,27], и лишь в нескольких публикациях сообщалось о повышенном риске развития рака эндометрия у женщин с эндометриозом [28].…”

The Association Between Endometriosis and Surface Epithelial Ovarian Tumors: A Review of Pathological Data

“…Additionally, it has potential to increase the risk of ovarian epithelial tumor in nearby location. The mentioned association has frequently been reported in English-language literature (2,4,8,9). In 1925, Sampson et al described the first histopathological criteria for identification of ovarian tumors arising from endometriosis, including the proximity of endometriotic site and the tumor, the evidence of origination of tumor from endometriosis, and rule out tumor invasion into the endometriotic foci from other sources as well as the presence of endometrial stromal tissue around the endometrial glands (8,10).…”

“…The estimated prevalence of endometriosis is 2% to 10% in the premenopausal, 2% to 4% in post-menopausal women, and 25% to 80% of infertile ones (1)(2)(3)(4)(5)(6)(7). The most common site of occurrence in endometriosis is ovary, but different locations in pelvic area are frequently involved.…”