A study has unveiled startling connections between endometriosis and ovarian cancer risk. According to the findings, individuals with endometriosis face a four-fold increase in ovarian cancer risk.
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, leading to severe pelvic pain during menstruation, sexual intercourse, bowel movements, or urination. Symptoms may also include chronic pain, abdominal bloating, nausea, fatigue, and occasionally depression, anxiety, and infertility. Currently, there is no cure for endometriosis, and treatment typically focuses on managing symptoms.
The latest study published in the journal Jama Network also found that individuals with severe forms of endometriosis, such as deep infiltrating endometriosis or ovarian endometriomas (chocolate cysts), face a staggering 9.7-fold increase in the likelihood of developing ovarian cancer.
However, experts emphasize that ovarian cancer itself is rare among women, reassuring that there is no need for panic despite the increased risk associated with severe forms of endometriosis.
“It should be noted that, because of the rarity of ovarian cancer, the association with endometriosis only increased the number of cancer cases by 10 to 20 per 10,000 women,” said Karen Schliep, senior author.
“We would not recommend, at this point, any change in clinical care or policy. The best way of preventing ovarian cancer is still the recommendation of exercise, not smoking and limiting alcohol,” Schliep said.
The researchers analyzed a vast dataset from the Utah Population Database involving approximately 500,000 women aged 18 to 55. By examining electronic health records spanning from 1992 to 2019, they meticulously tracked the incidence of endometriosis diagnoses and subsequent cases of ovarian cancer, drawing insights from the Utah Cancer Registry.
The study noted that the risk of all ovarian cancer types was 4.2-fold higher among women with endometriosis, particularly the risk of type I ovarian cancer. The highest risk was seen in women with deep infiltrating endometriosis.
“Magnitudes of these associations varied by endometriosis subtype. Individuals diagnosed with deep infiltrating endometriosis and/or ovarian endometriomas had 9.66 times the risk of ovarian cancer when compared with individuals without endometriosis,” the researchers wrote.
The study did not specify whether women with endometriosis received treatment with oral contraceptives or gonadotropin-releasing hormone agonists. This lack of distinction could slightly influence the data, given that birth control pills are linked to a reduced risk of ovarian cancer, and the risk related to gonadotropin-releasing hormone agonists is not known. Also, there is a chance that participants who reported not having endometriosis may be undiagnosed.
However, the study findings highlight the need for counseling for women with severe endometriosis regarding their increased risk of ovarian cancer.
“In those women who have completed childbearing or have alternative fertility options, consideration for more definitive surgery should be discussed and considered. As always, shared decision-making is essential given these evolving data,” Dr. Michael McHale from the University of California wrote in an editorial accompanying the study.
