Association between endometriosis and gynecological cancers: a critical review of the literature

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This review critically presents evidence on endometriosis associations with gynecological cancers, finding support for an ovarian cancer link, particularly endometrioid and clear cell subtypes, but no clear association with endometrial, cervical, or breast cancer.

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Abstract

Background Endometriosis is one of the most common benign gynecological diseases with an occurrence approximately 10% in reproductive age. Endometriosis has been proposed as a possible precursor of certain ovarian carcinomas such as clear cell and endometrioid ovarian carcinomas. In addition to this pathogenic link, the association with other gynecological tumors and breast cancer has been studied on an epidemiological basis in several studies.

Objective

The aim of this review was to critically present the recent published evidence on the association of endometriosis with gynecological cancer, and with a special emphasis on ovarian cancer.

Materials and methods

A search for eligible studies was conducted in three electronic databases, MEDLINE, EMBASE and CINAHL, for original research in humans published in any language.

Results

The present review includes studies examining the association between endometriosis and different types of gynecological cancer (i.e., 25 studies on ovarian cancer, 8 studies on breast cancer, 8 studies on endometrial cancer and 2 studies on cervical cancer).

Conclusion

The present literature supports the pre-existing evidence suggesting an association between ovarian cancer and endometriosis and specifically its two histologic subtypes (endometrioid and ovarian clear cell cancer). The most recent population-based epidemiological studies cannot provide a clear association between endometriosis and endometrial, cervical or breast cancer. Similar content being viewed by others

References

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Pathol Res Pract 210(4):250–255. https://doi.org/10.1016/j.prp.2013.12.011 Govindan S et al (2007) Association of progesterone receptor gene polymorphism (PROGINS) with endometriosis, uterine fibroids and breast cancer. Cancer Biomark 3(2):73–78 Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Author information Authors and Affiliations Contributions DRK, SMI, and KPE: project development, data collection, and manuscript writing. AM: data collection. EPS and AD: manuscript writing Corresponding author Ethics declarations Conflict of interest The authors declare no potential conflicts of interest. Ethical approval This article contains already published data. Informed consent statement No informed consent was needed, as all the studies included in this review are already published. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Kalaitzopoulos, D.R., Mitsopoulou, A., Iliopoulou, S.M. et al. Association between endometriosis and gynecological cancers: a critical review of the literature. Arch Gynecol Obstet 301, 355–367 (2020). https://doi.org/10.1007/s00404-020-05445-1 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00404-020-05445-1

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Breast Neoplasms Carcinoma, Endometrioid Endometrial Neoplasms Endometriosis Genital Neoplasms, Female Ovarian Neoplasms Uterine Cervical Neoplasms Adult Breast Neoplasms Carcinoma, Endometrioid Endometrial Neoplasms Endometrial Neoplasms Endometriosis Endometrium Endometrium Female Genital Neoplasms, Female Gynecology Humans Middle Aged

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