[A national questionnaire survey of the current status of diagnosis and treatment of endometriosis in China in 2024]

Objective: To investigate the current status of clinical practice and the implementation of existing guidelines for endometriosis in China, and to provide a reliable basis for relevant continuing medical education and future guideline revisions. Methods: A nationwide cross-sectional survey was conducted using convenience sampling. Doctors in obstetrics and gynecology or reproductive medicine were invited to complete an online questionnaire. The main survey contents included: the availability of specialized endometriosis clinics at the respondents' hospitals; the respondents' experience in diagnosing and surgically managing endometriosis; and their awareness and implementation of established clinical practice guidelines. Statistical analysis was performed on the collected valid questionnaires. Results: A total of 651 respondents from 30 provinces, municipalities, and autonomous regions across China participated, with 633 valid questionnaires collected. Obstetricians and gynecologists accounted for 92.73% (587/633) of the respondents, and over 90% held the professional title of attending physician or higher. 83.41% (528/633) of the respondents had performed or participated in surgical treatment for endometriosis. Compared to data from the survey in 2018, several indicators showed improvement: the establishment of specialized endometriosis clinics [9.97% (149/1 494) vs 22.91% (145/633)], the clinical implementation of the long-term management concept for endometriosis [35.54% (531/1 494) vs 54.34% (344/633)], and the routine clinical use of endometriosis fertility index scoring system [18.74% (280/1 494) vs 37.31% (197/528)]. Pain or dysmenorrhea (96.52%, 611/633) was the most valued diagnostic basis, and "alleviating or eliminating pain" (94.94%, 601/633) was the top treatment goal."How to prevent and protect fertility impaired by endometriosis" (91.82%, 438/477) was the most anticipated topic for future guideline updates. 68.09% (431/633) of the respondents preferred combined estrogen-progestogen regimens for perimenopausal endometriosis, and 84.36% (534/633) of the respondents reported utilizing an add-back regimen to alleviate menopausal symptoms induced by gonadotropin-releasing hormone agonist. Furthermore, 90.36% (572/633) of the respondents reported observing mental and psychological disorders in patients with endometriosis. Conclusions: This survey provides contemporary insights into the diagnosis and management of endometriosis in China, revealing a clear trend toward increasingly standardized and refined practices. Furthermore, the survey identifies unmet clinical expectations regarding current guidelines, thereby providing valuable references for the panel to more effectively promote and guide the advancement of clinical practices for endometriosis in China.