Incidence, prevalence, and trends in endometriosis diagnosis: a United States population-based study from 2006 to 2015

Christ, Jacob; Yu, Onchee; Schulze‐Rath, Renate; Grafton, Jane; Hansen, Kelly; Reed, Susan D.

doi:10.1016/j.ajog.2021.06.067

Cited by 34 publications

(38 citation statements)

References 38 publications

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“…However, when primary UE is associated with endometriosis at other, mainly pelvic, sites, the metastatic hypothesis appears also plausible. Of note, the prevalence of endometriotic pelvic lesions co-existent with primary UE was much higher than the usual estimates observed in the general premenopausal population [1][2][3][4]. This finding supports the possibility of a common etiological mechanism for the two disease locations because, if a separate pathogenesis exists for UE, the unusually high frequency of concomitant pelvic lesions would be difficult to explain.…”

Section: Discussionmentioning

confidence: 64%

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Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal

Dridi

Chiaffarino

Parazzini

et al. 2022

JCM

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Umbilical endometriosis represents 30–40% of abdominal wall endometriosis and around 0.5–1.0% of all cases of endometriosis. The aim of this systematic review is to revisit the epidemiology, signs, and symptoms and to formulate a pathogenic theory based on literature data. We performed a systematic literature review using the PubMed and Embase databases from 1 January 1950 to 7 February 2021, according to the PRISMA guidelines. The review was registered at PROSPERO (CRD42021239670). Studies were selected if they reported original data on umbilical endometriosis nodule defined at histopathological examination and described as the presence of endometrial glands and/or stromal cells in the connective tissue. A total of 11 studies (10 retrospective and one prospective), and 14 case series were included in the present review. Overall, 232 umbilical endometriosis cases were reported, with the number per study ranging from 1 to 96. Umbilical endometriosis was observed in 76 (20.9%; 95% CI 17.1–25.4) of the women included in studies reporting information on the total number of cases of abdominal wall endometriosis. Umbilical endometriosis was considered a primary form in 68.4% (158/231, 95% CI 62.1–74.1) of cases. A history of endometriosis and previous abdominal surgery were reported in 37.9% (25/66, 95% CI 27.2–49.9) and 31.0% (72/232, 95% CI 25.4–37.3) of cases, respectively. Pain was described in 83% of the women (137/165, 95% CI 76.6–88.0), followed by catamenial symptoms in 83.5% (142/170, 95% CI, 77.2–88.4) and bleeding in 50.9% (89/175, 95% CI 43.5–58.2). In the 148 women followed for a period ranging from three to 92.5 months, seven (4.7%, 95% CI 2.3–9.4) recurrences were observed. The results of this analysis show that umbilical endometriosis represents about 20% of all the abdominal wall endometriotic lesions and that over two thirds of cases are primary umbilical endometriosis forms. Pain and catamenial symptoms are the most common complaints that suggest the diagnosis. Primary umbilical endometriosis may originate from implantation of regurgitated endometrial cells conveyed by the clockwise peritoneal circulation up to the right hemidiaphragm and funneled toward the umbilicus by the falciform and round liver ligaments.

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Section: Discussionmentioning

confidence: 64%

“…Endometriosis is a benign gynecological disorder that affects about 5% of reproductiveaged women [1][2][3][4]. The pelvic cavity is the most common location of endometriotic implants, but about 12% of lesions are extragenital [5,6] and, among the extra-pelvic 2 of 16 sites, endometriosis of the abdominal wall (AWE) is the most common [7].…”

Section: Introductionmentioning

confidence: 99%

Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal

Dridi

Chiaffarino

Parazzini

et al. 2022

JCM

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“…Interestingly, our analysis showed that the number of instances of postmenopausal malignant transformation increased over time. Conversely, we know that other studies showed a negative trend over the years in the incidence of endometriotic disease [97,98]. Although these data may seem contradictory, these current occurrences may be those cases of asymptomatic endometriosis that occurred 20-30 earlier.…”

Section: Discussionmentioning

confidence: 87%

Malignant Transformation of Postmenopausal Endometriosis: A Systematic Review of the Literature

Giannella

Marconi

Giuseppe

et al. 2021

Cancers

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Objective: This study aimed to systematically review the existing literature on malignant transformation of postmenopausal endometriosis to provide information about patient characteristics, hormonal replacement therapy (HRT) use, and outcomes over a period of 52 years (1969–2021). Methods: According to PRISMA guidelines, we searched for (endometriosis OR endometriotic) AND (cancer OR malignancy OR malignant transformation) AND (menopause OR menopausal OR postmenopause OR postmenopausal) in Pubmed (all fields) (accessed on 12 February 2021) and Scopus (Title/Abstract/Keywords) (accessed on 12 February 2021) databases. The only filter used was the English language. Relevant articles were obtained in full-text format and screened for additional references. Eligibility/inclusion criteria: studies including full case description of malignant transformation of endometriosis-related lesions in postmenopause. Results: 75 studies, including 90 cases, were retrieved. The mean age was 55.8 ± 8.5 years. Overall, about 65% of women had a positive personal history of endometriosis/adenomyosis, and 64% of women underwent previous hysterectomy ± bilateral salpingo-oophorectomy. Forty-nine of 74 women used HRT (66.2%). Among the women who used HRT, estrogen-only treatment was taken by approximately 75%. Duration of HRT was longer than five years in 63.3% of cases. About 70% of subjects had histology of endometrioid adenocarcinoma or clear cell carcinoma. Follow-up outcome, available for 61 women, showed a survival rate of 78.7%, recurrence of 9.8%, death of 11.5%. The duration of follow-up had a median of 12 months (interquartile range, 6.75–25 months). Interestingly, over the years of case publication there was a significant inverse correlation with previous history of endometriosis (r = −0.28, p = 0.007), HRT use (r = −0.31, p = 0.006), and previous definitive surgery (r = −0.42, p < 0.001). Conclusions: In the malignant transformation of postmenopausal endometriosis, there are some recurrent clinical conditions: previous endometriosis, major definitive surgery before menopause, and estrogen-only HRT for a relatively long time. However, these clinical conditions have shown a drastic decrease over time. This could likely be the consequence of different attitudes and management of gynecologists linked to up-to-date scientific evidence about the use of major surgery in gynecological pathologies. Malignant transformation of postmenopausal endometriosis is a clinical challenge to be explored further.

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“…Recently, four population-based studies that examined the prevalence of endometriosis in the general population were reported [ 20 , 47 , 48 , 49 , 50 , 51 ]. The estimated overall prevalence of endometriosis in these population-based studies varies from 0.8–2.0% (approximately 3–5% in reproductive-aged women) [ 20 , 47 , 48 , 49 , 50 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Placenta Previa Complicated with Endometriosis: Contemporary Clinical Management, Molecular Mechanisms, and Future Research Opportunities

et al. 2021

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Endometriosis is a common gynecological disease characterized by chronic inflammation, with an estimated prevalence of approximately 5–15% in reproductive-aged women. This study aimed to assess the relationship between placenta previa (PP) and endometriosis. We performed a systematic review of the literature until 30 June 2021, and 24 studies met the inclusion criteria. Using an adjusted pooled analysis, we found that women with endometriosis had a significantly increased rate of PP (adjusted odds ratio (OR) 3.17, 95% confidence interval (CI) 2.58–3.89) compared to those without endometriosis. In an unadjusted analysis, severe endometriosis was associated with an increased prevalence of PP (OR 11.86, 95% CI 4.32–32.57), whereas non-severe endometriosis was not (OR 2.16, 95% CI 0.95–4.89). Notably, one study showed that PP with endometriosis was associated with increased intraoperative bleeding (1.515 mL versus 870 mL, p < 0.01) compared to those without endometriosis. Unfortunately, no studies assessed the molecular mechanisms underlying PP in patients with endometriosis. Our findings suggest that there is a strong association between endometriosis and a higher incidence of PP, as well as poor surgical outcomes during cesarean delivery. Therefore, the development of novel therapeutic agents or methods is warranted to prevent PP in women with endometriosis.

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Incidence, prevalence, and trends in endometriosis diagnosis: a United States population-based study from 2006 to 2015

Cited by 34 publications

References 38 publications

Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal

Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal

Malignant Transformation of Postmenopausal Endometriosis: A Systematic Review of the Literature

Placenta Previa Complicated with Endometriosis: Contemporary Clinical Management, Molecular Mechanisms, and Future Research Opportunities

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