Risk for and consequences of endometriosis: A critical epidemiologic review

Abstract

Endometriosis affects approximately 10% of women of reproductive age. Characteristics robustly associated with a greater risk for endometriosis include early age at menarche, short menstrual cycle length, and lean body size, whereas greater parity has been associated with a lower risk. Relationships with other potential characteristics including physical activity, dietary factors, and lactation have been less consistent, partially because of the need for rigorous data collection and a longitudinal study design. Critical methodologic complexities include the need for a clear case definition; valid selection of comparison/control groups; and consideration of diagnostic bias and reverse causation when exploring demographic characteristics, medical history, and lifestyle factors. Reviewers and editors must demand a detailed description of rigorous methods to facilitate comparison and replication to advance our understanding of endometriosis.

Thyroid cancer risk in women with infertility and association with fertility medications in Taiwan

“…We only were able to identify infertile patients who had sought medical evaluation. Women with infertility may receive more frequent thyroid check‐ups, which can contribute to selection bias and increase the detection of cancers . Further investigation is warranted to explore whether these clinical issues result in biased study population selection.…”

“…Women with infertility may receive more frequent thyroid check-ups, which can contribute to selection bias and increase the detection of cancers. 22 Further investigation is warranted to explore whether these clinical issues result in biased study population selection. Fourth, although the data regarding infertility and cancer diagnoses were highly reliable, the insurance claims data mainly were for the purposes of administrative billing and clinical verification.…”

Circular RNA expression profiles and bioinformatics analysis in ovarian endometriosis

“…Endometriosis is characterized by the presence of endometrium‐like tissues (including glandular and stromal tissues) outside the uterine cavity, associated with dysmenorrhea, chronic pelvic pain, and infertility (Borghese, Zondervan, Abrao, Chapron, & Vaiman, ; Giudice, ; Shafrir et al, ; Tomassetti & D'Hooghe, ) . As a common estrogen‐dependent gynecologic disorder, it affects up to 10% women of reproductive age and up to 50% of women with pelvic pain and/or infertility (Giudice, ; Shafrir et al, ; Tomassetti & D'Hooghe, ). Although a benign condition, it shares malignant biological behaviors like tissue invasion, local spread, distant metastasis, and relapse, and seriously influences women's physical and mental health (Matias‐Guiu & Stewart, ).…”

Why so null? Methodologic necessities to advance endometriosis discovery

“…However, the true rates of endometriosis are uncertain, in part because definitive diagnosis requires surgical visualisation . Estimates vary widely among population samples and paths diagnosis, with patient characteristics frequently associated with endometriosis that are also proxies of greater access to care (greater affluence and education attainment, for example) . Annual health care costs for endometriosis are ~$22 billion in the US alone, with overall economic costs far higher.…”

“…Perhaps less obvious but more critical to advance endometriosis discovery in population, clinical, and bench science are the issues of comparison/control group selection . The current study's analytic population was restricted to the operative cohort of the ENDO study .…”