Abstract
Simple SummaryPrevious research shows that women with endometriosis and adenomyosis have an increased ovarian cancer risk. However, it is unclear whether these women have an increased risk of developing uterine cancer. This information is of key importance to women with endometriosis or adenomyosis. Therefore, this study aims to assess the uterine cancer risk in women with endometriosis or adenomyosis in a large population.Women with histologically proven endometriosis/adenomyosis have an increased risk of ovarian cancer. Small studies show conflicting results on the endometrial cancer risk in women with endometriosis/adenomyosis. Therefore, we assessed the incidence of endometrial cancer in women with histologically proven endometriosis or adenomyosis. We performed a population-based retrospective cohort study of 129,862 women with histologically proven endometriosis/adenomyosis, matched with 132,700 women with a nevus selected from the Dutch pathology registry between 1990 and 2015. Histology results for endometrial cancer were retrieved. Crude and age-adjusted odds ratios for endometrial cancer were estimated. In the endometriosis/adenomyosis group, 1827 (1.4%) women had a histological report on endometrial cancer, and in the nevus group, 771 (0.6%) women. The age-adjusted OR for endometrial cancer was 2.58 (95%CI 2.37–2.81). After excluding the first year of follow-up, the age-adjusted OR was 0.76 (95%CI 0.63–0.92), indicating that endometrial cancer is most often found at time of histological diagnosis of endometriosis/adenomyosis. In around 20% of the endometrial cancer cases, the endometrial cancer was not recognized until after hysterectomy. Of these women, 35% had no prior (micro)curettage or biopsy. This study shows an increased incidence of endometrial cancer in women with histologically proven endometriosis and adenomyosis.
Highlights
Endometriosis and adenomyosis are prevalent benign gynecological conditions in which endometrial-like glands and stroma are present outside the uterine cavity or in the myometrium, respectively [1,2,3,4]
3317 women were excluded in the endometriosis/adenomyosis cohort, as 1788 had adenomyomatosis of the gallbladder, 1475 had solely endosalpingiosis, 48 had a corpus rubrum cyst without endometriosis/adenomyosis, and six women had endocervicosis
Women with a censoring date more than half a year before start diagnosis were excluded, which resulted in 132,700 women in the nevus cohort and 129,862 in the endometriosis/adenomyosis cohort
Summary
Endometriosis and adenomyosis are prevalent benign gynecological conditions in which endometrial-like glands and stroma are present outside the uterine cavity or in the myometrium, respectively [1,2,3,4]. The five most common histopathological subtypes are endometrioid, clear-cell, serous, mucinous endometrial cancer and adenocarcinoma not otherwise specified (NOS) [8]. Several studies have shown that endometriosis is associated with an increased risk of ovarian cancer, endometrioid and clear cell ovarian subtypes [9,10,11]. Contradictory evidence exists as to whether endometriosis and adenomyosis are associated with endometrial cancer [11,12,13,14,15]. Most studies included women with clinical or surgical endometriosis/adenomyosis, whereas histological diagnosis is still considered the gold standard [2]. Studies on adenomyosis and endometrial cancer included small samples sizes [13,14,15]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call