Pelvic inflammatory disease is associated with ovarian cancer development in women with endometriosis: A cohort study in Taiwan

Hui-Wen Lo, Hui‐Wen Lo, Shih-Feng Weng, Shih‐Feng Weng, Hung-Sheng Chen, Hung‐Sheng Chen, Eing-Mei Tsai, Eing‐Mei Tsai
International Journal of Gynecology & Obstetrics · 2021 · vol. 158(1) , pp. 145–152 · doi:10.1002/ijgo.13935 · PMID:34536967 · W3201083837
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This cohort study found that women with endometriosis and subsequent pelvic inflammatory disease had a significantly higher risk of developing ovarian cancer compared to women with endometriosis alone.

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Abstract

OBJECTIVE: Endometriosis and pelvic inflammatory disease are considered to be risk factors for ovarian cancer, as dysbiosis probably contributes to ovarian cancer development via chronic inflammation and immune response alteration. Therefore, we hypothesized that pelvic inflammatory disease predisposes to ovarian cancer development in women with endometriosis. METHODS: We selected patients who were diagnosed with endometriosis or pelvic inflammatory disease between January 1, 2000 and December 31, 2015, in a 2 million longitudinal health and welfare database in Taiwan with cancer and death registries. Patients were divided into five groups: (1) those with endometriosis, (2) those with pelvic inflammatory disease, (3) those with endometriosis diagnosed before pelvic inflammatory disease, (4) those with pelvic inflammatory disease diagnosed before endometriosis, and (5) healthy women. Propensity score matching with inverse probability of treatment weighting was used to adjust for covariates across the study groups. RESULTS: The risk of ovarian cancer was significantly higher in women with endometriosis and subsequent pelvic inflammatory disease than in those with endometriosis alone (hazard ratio 8.07; 95% confidence interval 4.53-14.37; P < 0.001). The same result was found for ovarian cancer incidence per 1000 person-years. CONCLUSION: Our data show that pelvic inflammatory disease is associated with cancer development in women with pre-existing endometriosis.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Pelvic Inflammatory Disease Pelvic Inflammatory Disease Pelvic Inflammatory Disease Carcinoma, Ovarian Epithelial Carcinoma, Ovarian Epithelial Case-Control Studies Cohort Studies Female Humans Taiwan Taiwan

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