Endometriosis as a risk factor for Ovarian or Endometrial Cancer – Results of a hospital based case control study

S. Burghaus, L Häberle, MG Schrauder, K Heusinger, FC Thiel, Alexander Hein, A Hein, D. Wachter, J Strehl, A Hartmann, AB Ekici, Arif B. Ekici, M.W. Beckmann, PA Fasching, SP Renner, Stefan P. Renner
Geburtshilfe und Frauenheilkunde · 2015 · vol. 75(07) · doi:10.1055/s-0035-1558373 · W4247078036
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This hospital-based case-control study investigated endometriosis as a potential risk factor for ovarian or endometrial cancer, aiming to identify sub-populations with higher incidence for targeted screening.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This hospital-based case-control study assessed whether endometriosis is associated with ovarian or endometrial cancer, using 289 cancer cases (endometrial or ovarian cancer) and 1016 population controls recruited via newspaper advertisement. Logistic regression models evaluated predictors including age, number of pregnancies, previous oral contraceptive use, and additionally whether participants had been diagnosed with endometriosis, with model comparison by likelihood ratio tests. Endometriosis was more frequent among cases than controls (4.8% vs 2.1%), and endometriosis was associated with case-control status (OR = 2.53, 95% CI 1.23–5.21), while previous oral contraceptive use was inversely associated (OR = 0.41, 95% CI 0.30–0.55). This paper is centrally about endometriosis — it tests endometriosis as a risk factor for endometrial or ovarian cancer and reports its effect in a case-control prediction context.

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Abstract

There is no screening program for ovarian or endometrial cancer. One reason for that could be the relatively low incidence with subsequently low positive predictive values for tests with low specifity. One way to address the problem could be the utilization of risk factors to define sub-populations with a higher incidence. Recently, there were hints that endometriosis could be a risk factor for ovarian cancer.
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Background

There is no screening program for ovarian or endometrial cancer. One reason for that could be the relatively low incidence with subsequently low positive predictive values for tests with low specifity. One way to address the problem could be the utilization of risk factors to define sub-populations with a higher incidence. Recently, there were hints that endometriosis could be a risk factor for ovarian cancer.

Methods

We conducted a hospital based case control analysis. Cases were patients with endometrial or ovarian cancer who participated in studies aiming at risk assessment for these diseases. Controls were women who were invited by newspaper advertisement. A total of 289 cases and 1016 controls were included. Two logistic regression models were used, one with the predictor's age, number of pregnancies and previous oral contraceptive (OC) use and another one including additionally whether the patient was diagnosed with endometriosis. Both models were compared with the likelihood ratio test.

Results

Endometriosis was present in 21 controls (2.1%) and 14 cases (4.8%). Relevant predictors for case control status were previous OC use (OR = 0.41; 95% CI: 0.30 – 0.55) and endometriosis (OR = 2.53; 95% CI: 1.23 – 5.21). The prediction model that included endometriosis was slightly better (p = 0.01, likelihood ratio test) than the model without endometriosis (AUC = 0.67 vs. AUC = 0.66).

Conclusion

In our case control study endometriosis could be described as a risk factor for endometrial or ovarian cancer. Studies addressing this question are rare and the implementation into a clinical prediction model would demand a precise characterization of the risk factor endometriosis. For this purpose we initiated a multicentric cohort study (www.myendometriosis.org), the International Endometriosis Evaluation Program where centers all over the world are invited to participate.

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endometriosis

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