Women with endometriosis have approximately a fourfold higher risk of developing ovarian cancer compared to those without the condition, a new study reveals. While scientists have long suspected a link between endometriosis and ovarian cancer, this research highlights how different subtypes of endometriosis can influence the risk (1^✔ ✔Trusted Source
Endometriosis and Ovarian Cancer: an Integrative Review (Endometriosis and Ovarian Cancer)

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Cancer Risk Among Women with Endometriosis

Endometriosis is a prevalent and often painful condition where tissue similar to the uterine lining grows outside the uterus. It affects over 11% of women aged 15 to 44 in the United States.

Women with severe forms of endometriosis, such as deep infiltrating endometriosis and ovarian endometriomas, face an increased ovarian cancer risk of about 9.7 times higher than those without endometriosis, according to the study published in JAMA. Deep infiltrating endometriosis occurs deep within tissues or organs, while ovarian endometriomas, also known as “chocolate cysts,” are cysts that form on the ovaries.

The study indicates that women with deep infiltrating endometriosis or ovarian endometriomas have nearly 19 times the risk of developing type I ovarian cancer, which typically grows more slowly, compared to women without endometriosis.

Ovarian Cancer Remains Rare

Experts advise that people with endometriosis should not be alarmed by these findings, as ovarian cancer remains rare. According to the National Cancer Institute, about 1.1% of US women will be diagnosed with ovarian cancer during their lifetime, with nearly 20,000 new cases and about 13,000 deaths expected this year.

Karen Schliep, senior author of the study and associate professor at the University of Utah School of Medicine, stated, “The association with endometriosis increased the number of cancer cases by 10 to 20 per 10,000 women.” She emphasized the importance of maintaining healthy habits, such as regular exercise, avoiding smoking, and limiting alcohol, as the best ways to prevent ovarian cancer.

Look out For Signs of Ovarian Cancer

Dr. BJ Rimel, a gynecologic oncologist at Cedars-Sinai, recommends that people with endometriosis stay vigilant for ovarian cancer warning signs, including bloating, abdominal pain, and changes in bowel or bladder function. She also highlighted the protective effects of oral contraceptive pills, which can reduce the risk of ovarian cancer by 50%.

The study analyzed data from nearly 500,000 women in Utah, aged 18 to 55, using the Utah Population Database and Utah Cancer Registry. Researchers found that the risk of all ovarian cancer types was 4.2 times higher in women with endometriosis. Specifically, the risk of type I ovarian cancer was about 7.5 times higher, and the risk of type II ovarian cancer, which is more aggressive, was 2.7 times higher.

The researchers discovered that women with deep infiltrating endometriosis had an 18.8 times higher risk of ovarian cancer, while those with both deep infiltrating endometriosis and ovarian endometriomas had a 13-fold higher risk. These findings were unexpected for the research team.

Birth Control Pills Lowers Risk of Ovarian Cancer

The study did not account for women treated with oral contraceptives or gonadotropin-releasing hormone agonists, which could influence the data, as birth control pills are linked to a lower ovarian cancer risk. Additionally, some women without a formal endometriosis diagnosis may have been undiagnosed or misdiagnosed.

The study adds to the growing body of evidence linking endometriosis with ovarian cancer risk. Dr. Michael McHale of the University of California, San Diego, stressed the importance of counseling women with deep infiltrating endometriosis about their increased cancer risk. He suggested that those who have completed childbearing or have alternative fertility options consider more definitive surgical interventions.

Dr. Tatnai Burnett of the Mayo Clinic highlighted that the overall cancer risk remains low, even with the increased association between endometriosis and ovarian cancer. He noted that current recommendations for monitoring women with endometriomas or cystic endometriosis using ultrasound to detect malignancy will likely remain unchanged.

While the study shows a significant association between endometriosis and ovarian cancer, it does not establish causation. More research is needed to understand the underlying mechanisms fully. For now, women with endometriosis should be aware of the potential increased risk but also recognize that ovarian cancer remains relatively rare.

Reference:

1. Endometriosis and Ovarian Cancer: an Integrative Review (Endometriosis and Ovarian Cancer) – (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5563086/)

Source-Medindia