The Risk of Epithelial Ovarian Cancer of Women With Endometriosis May be Varied Greatly if Diagnostic Criteria Are Different

Wen-Ling Lee, Wen-Hsun Chang, Kuan-Chin Wang, Chao‐Yu Guo, Chao-Yu Guo, Yiing‐Jeng Chou, Yiing-Jeng Chou, Nicole Huang, Hsin-Yi Huang, Hsin‐Yi Huang, Ming-Shyen Yen, Ming‐Shyen Yen, Peng-Hui Wang, Peng‐Hui Wang
Medicine · 2015 · vol. 94(39) , pp. e1633 · doi:10.1097/md.0000000000001633 · PMID:26426652 · W2331977245
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This study found that the risk of epithelial ovarian cancer in women with endometriosis significantly varies depending on the diagnostic criteria, ranging from a 1.90 to 18.57 adjusted hazard ratio compared to women without endometriosis.

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Abstract

This article aims to test the hypothesis that the risk of epithelial ovarian cancer (EOC) in women with endometriosis might be changed by enrolling different population. A nationwide 14-year historic cohort study using the National Health Insurance Research Database (NHIRD) of Taiwan and the Registry for Catastrophic Illness Patients was conducted. A total of 239,385 women aged between 20 and 51 years, with at least 1 gynecologic visit after 2000, were analyzed. Cases included women with a diagnosed endometriosis, which was established along a spectrum from at least 1 medical record of endometriosis (recalled endometriosis) to tissue-proved ovarian endometriosis (n = X). Controls included women without any diagnosis of endometriosis (n = 239,385 - X). We used Cox regression, and computed hazard ratios (HRs) with 95% confidence intervals (95% CI) to determine the risk of EOC in patients. The EOC incidence rates (IRs, per 10,000 person-years) of women with endometriosis ranged from 1.90 in women with recalled endometriosis to 18.70 in women with tissue-proved ovarian endometrioma, compared with those women without any diagnosis of endometriosis (0.77-0.89), contributing to crude HRs ranging from 2.59 (95% CI, 2.09-3.21; P < 0.001) to 24.04 (95% CI, 17.48-33.05; P < 0.001). After adjustment for pelvic inflammatory disease, infertility, Charlson co-morbidity index, and age, adjusted HRs were ranged from the lowest of 1.90 (95% CI, 1.51-2.37; P < 0.001) in recalled endometriosis to the highest of 18.57 (95% CI, 13.37-25.79; P < 0.001) in tissue-proved ovarian endometrioma, which was inversely related to the prevalence rate of endometriosis (from the highest of 30.80% in recalled endometriosis to the lowest of 1.54% in tissue-proved ovarian endometrioma). The risk of EOC in women with endometriosis varied greatly by different criteria used. Women with endometriosis might have a more apparently higher risk than those reported by systematic review and meta-analysis.

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Condition tags

mesh:D004715endometriosisendometriomainfertility

MeSH descriptors

Endometriosis Endometriosis Neoplasms, Glandular and Epithelial Ovarian Neoplasms Adult Carcinoma, Ovarian Epithelial Case-Control Studies Catastrophic Illness Cohort Studies Databases, Factual Endometriosis Endometriosis Female Humans Incidence Middle Aged National Health Programs Neoplasms, Glandular and Epithelial Neoplasms, Glandular and Epithelial Ovarian Neoplasms

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