Incidence of ovarian cancer after bilateral salpingo-oophorectomy in women with histologically proven endometriosis

Marjolein Hermens, van Altena AM, Anne M. van Altena, Bulten J, Johan Bulten, van Vliet HAAM, Huib A. A. M. van Vliet, Albert G. Siebers, Ruud L M Bekkers
Fertility and sterility · 2022 · vol. 117(5) , pp. 938–945 · doi:10.1016/j.fertnstert.2022.01.030 · PMID:35300832 · W4220838856
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This study investigated the incidence of ovarian cancer in women who underwent bilateral salpingo-oophorectomy for histologically confirmed endometriosis.

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Abstract

ObjectiveTo assess the incidence of ovarian cancer in women with histologically proven endometriosis after bilateral salpingo-oophorectomy (BSO).DesignRetrospective nationwide cohort study.SettingDutch pathology database.Patient(s)Women with histologically proven endometriosis who had undergone BSO between 1990 and 2015 (n = 7,984). This study consists of 2 control cohorts: women with histologically proven endometriosis without BSO (n = 42,633) and women with a benign dermal nevus (n = 132,535).Intervention(s)Observational study.Main outcome measure(s)Number of histologic diagnoses of (extra-)ovarian cancers. Incidence rate ratios (IRR) were estimated for (extra-)ovarian cancer. The number needed to treat was calculated.Result(s)We identified 9 (0.1%) (extra-)ovarian cancers in the BSO cohort and 170 (0.4%) and 444 (0.3%) ovarian cancers in the endometriosis and nevus control cohorts, respectively. We found an age-adjusted IRR of 0.34 (95% confidence interval [CI], 0.15-0.76) when the BSO cohort was compared with the endometriosis cohort. Comparing the BSO cohort with the nevus control cohort resulted in an age-adjusted IRR of 0.38 (95% CI, 0.17-0.85). The number needed to treat when the BSO cohort was compared with the endometriosis control cohort was 351 (95% CI, 272-591).Conclusion(s)In this nationwide study, we found that the (extra-)ovarian cancer incidence in women with histologically proven endometriosis decreased to less than the background population risk after BSO. Additionally, we found a significant reduction of the incidence of ovarian cancer when compared with women with histologically proven endometriosis without BSO. Endometriosis surgery could in the future be a preventive strategy in women with endometriosis and a high-risk profile for ovarian cancer.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Nevus Nevus Nevus Nevus Nevus Nevus Nevus Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms

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