Endometriosis as a Risk Factor for Epithelial Ovarian Cancer: Sub-types, Mechanisms and Risk Stratification

Ann Mini Mathew
In: International Journal of Medical Discoveries · 2026 · vol. 02(01) , pp. 112–121 · doi:10.64220/ijmd.v2i1.11 · W7154191893
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This integrative literature review examines the association between endometriosis and epithelial ovarian cancer, focusing on subtype-specific risks and underlying molecular mechanisms. The authors analyze epidemiologic and molecular studies to identify that ovarian endometriomas present the highest potential for malignant transformation into clear-cell and endometrioid carcinomas. Key drivers of this oncogenic progression include chronic inflammation, hormonal imbalances, oxidative stress, and specific genetic mutations in ARID1A, PIK3CA, and PTEN. The paper concludes that integrating clinical imaging features with molecular data can improve risk stratification and early intervention strategies for patients with endometriosis. This paper is centrally about endometriosis — specifically its role as a significant risk factor for developing epithelial ovarian cancer subtypes such as clear cell and endometrioid carcinoma.

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Abstract

Background: Endometriosis is a common gynecologic condition that may increase the risk of certain ovarian cancers, particularly clear-cell and endometrioid subtypes. Objective: To review subtype-specific risks, molecular mechanisms, and clinical risk stratification of endometriosis-associated ovarian cancer. Method: An integrative literature review was conducted, covering studies published between 2003 and 2025. Databases searched included PubMed, Scopus, Web of Science, EMBASE, and the Cochrane Library. Keywords included “endometriosis,” “ovarian cancer,” “endometrioma,” “malignant transformation,” “risk stratification,” and “molecular pathways.” Both epidemiologic and molecular studies reporting on endometriosis and epithelial ovarian cancer were included. Results: Ovarian endometriomas showed the highest potential for malignant transformation. Chronic inflammation, hormonal imbalances, oxidative stress, and mutations in ARID1A, PIK3CA, and PTEN contribute to oncogenic progression. Clinical and imaging features, including cyst size, growth rate, and solid components, help identify high-risk patients. Conclusion: Risk-stratified monitoring and early intervention can improve detection and outcomes, and future research should integrate molecular and clinical data for personalized management of endometriosis.
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Background

Endometriosis is a common gynecologic condition that may increase the risk of certain ovarian cancers, particularly clear-cell and endometrioid subtypes.

Objective

To review subtype-specific risks, molecular mechanisms, and clinical risk stratification of endometriosis-associated ovarian cancer.

Method

An integrative literature review was conducted, covering studies published between 2003 and 2025. Databases searched included PubMed, Scopus, Web of Science, EMBASE, and the Cochrane Library. Keywords included “endometriosis,” “ovarian cancer,” “endometrioma,” “malignant transformation,” “risk stratification,” and “molecular pathways.” Both epidemiologic and molecular studies reporting on endometriosis and epithelial ovarian cancer were included.

Results

Ovarian endometriomas showed the highest potential for malignant transformation. Chronic inflammation, hormonal imbalances, oxidative stress, and mutations in ARID1A, PIK3CA, and PTEN contribute to oncogenic progression. Clinical and imaging features, including cyst size, growth rate, and solid components, help identify high-risk patients.

Conclusion

Risk-stratified monitoring and early intervention can improve detection and outcomes, and future research should integrate molecular and clinical data for personalized management of endometriosis. Endometriosis, Risk Factor, Epithelial Ovarian Cancer, Endometrioma, Clear cell carcinoma.

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endometriosisendometrioma

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last seen: 2026-07-13T06:06:44.528863+00:00
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