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This dissertation investigates the long-term health implications of endometriosis, specifically examining its association with cutaneous melanoma and colorectal cancer within a prospective cohort of 49,255 women from the Sister Study. The research also addresses disparities in diagnostic experiences by conducting qualitative interviews with 25 Black women to understand how race and ethnicity influence the journey toward diagnosis. Key findings highlight the need for better understanding of these comorbidities and the significant gaps in current literature regarding non-Caucasian populations. This paper is centrally about endometriosis — it evaluates future cancer risks associated with the condition and analyzes racial disparities in the diagnostic process.
Abstract
Endometriosis is estimated to affect 10% of reproductive-age women: approximately 6.5 million women in the United States, and 190 million women worldwide. Endometriosis is a painful and chronic inflammatory disease characterized by the growth of endometrial-like tissue outside of the uterus. Endometriosis is a difficult disease to diagnose due to nonspecific symptoms, lack of awareness, and symptom normalization. This results in long diagnostic delays; the time from the start of symptoms to diagnosis is estimated to be on average 7 years. Individuals with endometriosis are more likely to have coexisting chronic conditions, including cancer; however, the exact mechanisms remain unclear. Furthermore, the association between endometriosis and both melanoma and colorectal cancer remains unclear due to previous studies with significant bias. To better understand the sequelae of endometriosis, we prospectively investigated the relationship between endometriosis and cutaneous melanoma, and colorectal cancer, in Chapters 1 and 2,respectively. We examined these associations in the Sister Study, a prospective cohort of 49,255 women aged 35 to 76 years old in the United States. To date, the majority of endometriosis research is conducted among Caucasian women, lacking critical information on race and ethnicity. As a result, little is known about the experiences of endometriosis diagnosis among Black, Asian, and Hispanic women. For Chapter 3, we conducted a qualitative study to understand the role of race and ethnicity in the patient's journey to endometriosis diagnosis among 25 Black women.
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THE IMPACT OF ENDOMETRIOSIS: EVALUATING FUTURE CANCER RISK AND UNDERSTANDING THE ROLE OF RACE AND ETHNICITY IN THE DIAGNOSTIC JOURNEY
Citations
Abstract
Endometriosis is estimated to affect 10% of reproductive-age women: approximately 6.5 million women in the United States, and 190 million women worldwide. Endometriosis is a painful and chronic inflammatory disease characterized by the growth of endometrial-like tissue outside of the uterus. Endometriosis is a difficult disease to diagnose due to nonspecific symptoms, lack of awareness, and symptom normalization. This results in long diagnostic delays; the time from the start of symptoms to diagnosis is estimated to be on average 7 years.
Individuals with endometriosis are more likely to have coexisting chronic conditions, including cancer; however, the exact mechanisms remain unclear. Furthermore, the association between endometriosis and both melanoma and colorectal cancer remains unclear due to previous studies with significant bias. To better understand the sequelae of endometriosis, we prospectively investigated the relationship between endometriosis and cutaneous melanoma, and colorectal cancer, in Chapters 1 and 2,respectively. We examined these associations in the Sister Study, a prospective cohort of 49,255 women aged 35 to 76 years old in the United States.
To date, the majority of endometriosis research is conducted among Caucasian women, lacking critical information on race and ethnicity. As a result, little is known about the experiences of endometriosis diagnosis among Black, Asian, and Hispanic women. For Chapter 3, we conducted a qualitative study to understand the role of race and ethnicity in the patient's journey to endometriosis diagnosis among 25 Black women.
Type
Dissertation (5 Years Campus Access Only)
Date
2026-02
Publisher
Degree
License
Attribution-NonCommercial-NoDerivs 3.0 United States
License
http://creativecommons.org/licenses/by-nc-nd/3.0/us/
Research Projects
Organizational Units
Journal Issue
Embargo Lift Date
2027-02-01
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