Are there any risk factor associated with the progression of endometriosis to ovarian cancer?

"Taiwanese insurance research database" related risk factors associated with the progression of endometriosis to ovarian cancer

Key Points

Importance:

• The study aimed to identify risk factors associated with the progression from endometriosis to ovarian cancer based on medical insurance data.

Highlights:

• If we know the risk factors for progression of endometriosis to cancer, they may help to gynecologists to identify and treat high-risk patients accordingly.

Key Results:

• Women who are diagnosed with endometriosis have an increased risk of developing ovarian cancer.
• This study has found that the risk factors associated with this association include increased age, pelvic inflammation, depression, and absence of childbearing after diagnosis of endometriosis.

Limitations of the study:

• Reliance upon ICD codes as the sole inclusion criteria for the analysis.
• In some findings such as the absence of post-endometriosis childbearing, it would be assumed that women who had severe disease would have fertility problems. Thus, these factors could be considered to be associations rather than direct causes of disease progression.  

Lay Summary

Endometriosis is a disease whereby endometrial glands proliferate outside of the endometrial lining. Apart from causing significant morbidity, It has been found that endometriosis is associated with an increased risk of progression to endometroid and clear cell ovarian cancer. However, the exact mechanisms of this progression are still being studied. For clinicians, understanding the risk factors that are associated with this progression may identify individuals who are at higher risk and conduct appropriate screening measures.

In this study, patient information taken from the National Health Insurance Research Database (NHIRD) in Taiwan from 2000-2013 included 229,617 patients who were initially admitted for endometriosis. These patients were then tracked for subsequent diagnoses of ovarian cancer and their social, economic, and medical comorbidities such as heart disease, diabetes, and gynecologic history were noted.

Of the approximately 230,000 patients included into the analysis, 1,473 developed ovarian cancer by the end of 2013.

Authors found that many factors including age, residence in an urbanized location, the absence of post-endometriosis childbearing, pelvic inflammation, and depression had an independent association on progression to ovarian cancer.

Some limitations of this study include reliance upon ICD codes as the sole inclusion criteria for the analysis. Additionally, in some findings such as the absence of post-endometriosis childbearing, it would be assumed that women who had severe disease would have fertility complications. Thus, these factors could be considered to be associations rather than direct causes of disease progression. Thus, further studies are required to identify and substantiate these risk factors.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29400021