Cancers in Patients with Endometriosis

S Blum, Lothar Häberle, Garri Tchartchian, Cordula Schippert, Tanja Fehm, C. Hartung, Peter Widschwendter, S Reicke, T Füger, Ariane Germeyer, Peter Oppelt, J. Lange, Markus C. Fleisch, Stefan P. Renner, Alexander Hein, PA Fasching, M.W. Beckmann, Stefanie Burghaus
In: Geburtshilfe und Frauenheilkunde · 2018 · doi:10.1055/s-0038-1675455 · W2907233873
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This study aimed to determine the frequencies of various cancers occurring alongside endometriosis, a disease known to increase the risk of certain ovarian cancers.

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This retrospective study used the International Endometriosis Evaluation Program (IEEP) to characterize the frequencies of cancer diagnoses recorded as comorbidities among 4,539 endometriosis patients (after exclusions for missing surgical diagnosis, lesion location, or comorbidity documentation). Cancer prevalence was 2.4% overall, with the highest documented prevalence in patients with peritoneal endometriosis paired with adenomyosis (3.2%); endometrial cancer cases were concentrated in the adenomyosis group (4 of 5), and most ovarian cancer cases occurred among patients with ovarian endometriosis. The authors note a key limitation that the number of patients with cancer was small, leaving uncertainty despite observed differences between lesion/location groups. This paper is centrally about endometriosis — and specifically compares cancer comorbidity frequencies across endometriosis lesion types including adenomyosis-only, using IEEP registry data.

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Abstract

It is known that endometriosis is associated with an increased risk for certain forms of ovarian cancer. However it is unknown, which kind of endometriosis is associated with ovarian cancer and furthermore, if endometriosis is associated with the risk for other cancers than ovarian cancer. However similar to other diseases endometriosis is a heterogeneous disease having different effects on pain or fertility as well as endometriosis is located in several locations like peritoneum, ovaries, uterus and might even infiltrate adjacent organs. Aim of this study was to describe the freuqencies of cancers as co-morbidities in a population of endometriosis patients.
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Acknowledgement

The AGO-TraFo is grateful to the German Cancer Society (Deutsche Krebsgesellschaft e.V.) for their financial support of the 10th scientific symposium of the AGO-TraFo. Publication History Publication Date: 26 November 2018 (online)

Background

It is known that endometriosis is associated with an increased risk for certain forms of ovarian cancer. However it is unknown, which kind of endometriosis is associated with ovarian cancer and furthermore, if endometriosis is associated with the risk for other cancers than ovarian cancer. However similar to other diseases endometriosis is a heterogeneous disease having different effects on pain or fertility as well as endometriosis is located in several locations like peritoneum, ovaries, uterus and might even infiltrate adjacent organs. Aim of this study was to describe the freuqencies of cancers as co-morbidities in a population of endometriosis patients.

Material and methods

Within the International Endometriosis Evaluation Program (IEEP) a total of over 9523 patients have been documented beween February 2014 and July 2018. For this retrospective analysis patients had to be excluded without a documented surgical diagnosis of endometriosis. Further 560 patietns wer excluded without exact documentation of the location of the endometriosis lesion. No documentation of co-morbidities was done in 1697 patients resulting in the exclusion of those patients. Therefore the final study population consisted of 4539 endometriosis patients. Cancer diagnosis frequencies were calculated for the following 5 groups. Group 1: peritoneal endometriosis, group 2: peritoneal endometriosis and adenomyosis, group 3: adenomyosis only, group 4: peritoneal endometriosis and deep infiltrating endometriosis, group 5: ovarian endometriosis.

Results

With regard to the 4539 pateints, in 107 cases (2.4%) a malignant disease was documented. In patietns from group 2 the cancer prevalence was highest with 3.2% and 0.9% in the group of patients with deep infiltrating endometriosis. Interestingly of 5 endometrial cancers 4 were diagnosed in patients with adenomyosis and 2 of 3 ovarian cancers in the group of patients with ovarian endometriosis.

Conclusion

This study is one of the first to analyze cancer prevalence in a group of endometriosis patients. There is some evidence, that cancer might be more prevalent in the group of patients with peritoneal endometriosis paired with adenomyosis. However sample sizes of patients diseased with cancer is small. Therefore larger registries are needed to adress this question further.

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