Prevalence, Symptomatic Burden, and Diagnosis of Endometriosis in Canada: Cross-Sectional Survey of 30 000 Women

Singh, Sukhbir S.; Soliman, Ahmed M.; Rahal, Yasmine; Robert, Catherine; Defoy, Isabelle; Nisbet, Paul; Leyland, Nicholas

doi:10.1016/j.jogc.2019.10.038

Cited by 57 publications

(56 citation statements)

References 27 publications

(32 reference statements)

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“…Future research on this enigmatic disease has received global attention. 123 Major areas of focus include (1) disease heterogeneity suggesting possible subtypes or a syndrome with different phenotypes, (2) collaborative approaches across disciplines to understand the complex interplay of multiple factors, and (3) prompt action at the current time when governments and funding agencies have begun to appreciate the enormity of the problem. Underpinning the concept of improved outcomes for women with endometriosis is an understanding of the cellular causes of the disease, studied concurrently with the associated genomic, physiological, and developmental programs.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, 6 to 11% of reproductive-age women are diagnosed with endometriosis. [1][2][3] However, with a current diagnostic delay of 7 to 15 years, 101 it is likely that the proportion of women affected by endometriosis is much larger. While increased education of women, health care professionals, and the general public will gradually aid in preventing unnecessary diagnostic delay, it is unlikely to significantly reduce the time to diagnosis, as there is currently no single imaging technique or laboratory test that can diagnose all forms of endometriosis without surgery.…”

Section: Reducing Diagnostic Delaymentioning

confidence: 99%

“…Endometriosis is a chronic, inflammatory disease affecting between 6 and 11% of girls and women, [1][2][3] where cells of endometrial histology form lesions throughout the pelvic cavity and in rare cases at distant sites. There are three main types of endometriosis lesions: (1) endometriomas, which form within the ovaries; (2) deep infiltrating endometriosis (DIE) lesions, which invade the bowel and other organs; and (3) superficial lesions, which adhere to the surface of organs and the peritoneum.…”

mentioning

confidence: 99%

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Cellular Origins of Endometriosis: Towards Novel Diagnostics and Therapeutics

et al. 2020

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Endometriosis remains an enigmatic disease of unknown etiology, with delayed diagnosis and poor therapeutic options. This review will discuss the cellular, physiological, and genomic evidence of Sampson's hypothesis of retrograde menstruation as a cause of pelvic endometriosis and as the basis of phenotypic heterogeneity of the disease. We postulate that collaborative research at the single cell level focused on unlocking the cellular, physiological, and genomic mechanisms of endometriosis will be accompanied by advances in personalized diagnosis and therapies that target unique subtypes of endometriosis disease. These advances will address the clinical conundrums of endometriosis clinical care—including diagnostic delay, suboptimal treatments, disease recurrence, infertility, chronic pelvic pain, and quality of life. There is an urgent need to improve outcomes for women with endometriosis. To achieve this, it is imperative that we understand which cells form the lesions, how they arrive at distant sites, and what factors govern their ability to survive and invade at ectopic locations. This review proposes new research avenues to address these basic questions of endometriosis pathobiology that will lay the foundations for new diagnostic tools and treatment pathways.

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Section: Discussionmentioning

confidence: 99%

Section: Reducing Diagnostic Delaymentioning

confidence: 99%

mentioning

confidence: 99%

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Cellular Origins of Endometriosis: Towards Novel Diagnostics and Therapeutics

et al. 2020

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“…1 Approximately 6%-10% of the United States, Canadian, and European women of reproductive age are affected. [2][3][4][5][6] Endometriosis symptoms can include severe pelvic pain, even infertility. 7 In a global survey of 1000 women with endometriosis, including women from the United States, 68%-71% presented with pain, 22%-30% presented with infertility, and 7.3%-29% presented with an endometrioma.…”

Section: Introductionmentioning

confidence: 99%

The impact of high-risk and chronic opioid use among commercially insured endometriosis patients on health care resource utilization and costs in the United States

Estes

Soliman

Zivkovic³

et al. 2020

Womens Health (Lond Engl)

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Objectives: Evaluate all-cause and endometriosis-related health care resource utilization and costs among newly diagnosed endometriosis patients with high-risk versus low-risk opioid use or patients with chronic versus non-chronic opioid use. Methods: A retrospective analysis of IBM MarketScan® Commercial Claims data from 2009 to 2018 was performed for females aged 18 to 49 with newly diagnosed endometriosis (International Classification of Diseases, Ninth Edition code: 617.xx; International Classification of Diseases, Tenth Edition code: N80.xx). Two sub-cohorts were identified: high-risk (⩾1 day with ⩾90 morphine milligram equivalents per day or ⩾1-day concomitant benzodiazepine use) or chronic opioid utilization (⩾90-day supply prescribed or ⩾10 opioid prescriptions). High-risk or chronic utilization was evaluated during the 12-month assessment period after the index date. Index date was the first opioid prescription within 12 months following endometriosis diagnosis. All outcomes were assessed over 12-month post-assessment period while adjusting for demographic and clinical characteristics. Results: Out of 61,019 patients identified, 18,239 had high-risk opioid use and 5001 chronic opioid use. Health care resource utilization drivers were outpatient visits and pharmacy fills, which were higher among high-risk versus low-risk patients (outpatient visits: 17.49 vs 15.51; pharmacy fills: 19.58 vs 16.88, p < 0.0001). Chronic opioid users had a higher number of outpatient visits (19.53 vs 15.00, p < 0.0001) and pharmacy fills (23.18 vs 16.43, p < 0.0001) compared to non-chronic opioid users. High-risk opioid users had significantly higher all-cause health care costs compared to low-risk opioid users (US$16,377 vs US$13,153; p < 0.0001). Chronic opioid users also had significantly higher all-cause health care costs compared to non-chronic opioid users (US$20,930 vs US$12,272; p < 0.0001). Similar patterns were observed among endometriosis-related HCRU, except pharmacy fills among high-risk and chronic sub-cohorts. Conclusion: This analysis demonstrates significantly higher all-cause and endometriosis-related health care resource utilization and total costs for high-risk opioid users compared to low-risk opioid users among newly diagnosed endometriosis patients over 1 year. Similar trends were observed for comparing chronic opioid users with non-chronic opioid users, except for endometriosis-related pharmacy fills and associated costs.

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“…A cross-sectional online survey was performed to assess the symptomatic disease burden of endometriosis in Canada. 16 The present study examines survey responses related to the burden of fatigue and productivity impairment in Canadian women with a self-reported diagnosis of endometriosis (DxE). Three independent response panels were used as sampling frames: the Survey Sampling International panel (now Dynata, Shelton, CT; http://www.dynata.com), the Leger panel (Toronto, ON; https://leger360.com), and the Lightspeed panel (now Kantar, Vancouver, BC; http://lightspeedresearch.com).…”

Section: Study Design and Participantsmentioning

confidence: 99%

Impact of Endometriosis on Fatigue and Productivity Impairment in a Cross-Sectional Survey of Canadian Women

Soliman

Rahal

Robert

et al. 2021

Journal of Obstetrics and Gynaecology Canada

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Objective: To evaluate fatigue burden and productivity impairments in Canadian women with a self-reported diagnosis of endometriosis (DxE). Methods: From December 2018 to January 2019, Canadian women aged 18À49 years completed an online survey assessing fatigue via the Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Short Form 6a questionnaire. Fatigue T-scores were compared between women with and without a DxE, by age and endometriosis symptom severity, using t tests. Women with a DxE completed the Work Productivity and Activity Impairment − Specific Health Problem (WPAI-SHP) questionnaire. The effects of age and hallmark endometriosis symptoms on productivity impairments were assessed via analysis of variance. Results: Survey data included 2004 women with and 26 528 women without a DxE. Mean fatigue T-scores were 58.5 § 10.1 in women with a DxE and 59.2 § 10.1 in women with hallmark endometriosis symptoms (i.e., menstrual or non-menstrual pelvic pain/cramping, dyspareunia) versus 55.2 § 9.4 in women without a DxE (both P < 0.001). Women with moderate or severe endometriosis symptoms had a mean T-score of 61.2 § 9.4 versus 55.9 § 10.1 for women with mild symptoms (P < 0.001). Women with moderate or severe hallmark endometriosis symptoms had mean T-scores of 59.6−62.9 versus 57.0−58.2 for women with mild or no symptoms (all comparisons P < 0.01). Women with a DxE reported 17.1% of work time missed, 41.8% impaired work ability, 46.5% overall work impairment, and 41.4% activity impairment per the WPAI-SHP. Women with a DxE aged 30−34 and 35−39 years consistently experienced the greatest effects of fatigue and productivity impairments. Conclusions: Canadian women with a DxE experience a substantial fatigue burden and significant productivity impairments.

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Prevalence, Symptomatic Burden, and Diagnosis of Endometriosis in Canada: Cross-Sectional Survey of 30 000 Women

Cited by 57 publications

References 27 publications

Cellular Origins of Endometriosis: Towards Novel Diagnostics and Therapeutics

Cellular Origins of Endometriosis: Towards Novel Diagnostics and Therapeutics

The impact of high-risk and chronic opioid use among commercially insured endometriosis patients on health care resource utilization and costs in the United States

Impact of Endometriosis on Fatigue and Productivity Impairment in a Cross-Sectional Survey of Canadian Women

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