Endometriosis and ovarian cancer risk

Giorgio Bogani, Bogani G, Kathleen N. Moore, Moore KN, Isabelle Ray-Coquard, Ray-Coquard I, Ceccaroni M, Marcello Ceccaroni, Robert L. Coleman, Coleman RL, Christina Fotopoulou, Mohamed Mabrouk, Mabrouk M, Taylor HS, Hugh S. Taylor, Roman H, Horace Roman, Filippo A. Ferrari, Ferrari FA, Shailesh Puntambekar, Puntambekar S, Mario Malzoni, Malzoni M, Gaby N Moawad, Moawad GN, Gaby Moawad, Abrão MS, Mauricio S Abrão, Fernanda Herrera, Herrera F, Chiappa V, Valentina Chiappa, Giuseppe Vizzielli, Vizzielli G, F Raspagliesi, Raspagliesi F, Francesco Raspagliesi, Ainhoa Madariaga, Madariaga A, Brian M. Slomovitz, Slomovitz BM, Frédéric Amant, Amant F, Bradley J. Monk, Monk BJ, Kroep JR, Judith R. Kroep
Gynecologic Oncology · 2026 · vol. 209 , pp. 88–98 · doi:10.1016/j.ygyno.2026.05.004 · PMID:42119308 · W7160964366
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

Endometriosis is associated with a statistically significant increased risk of endometrioid and clear cell ovarian cancers, driven by shared molecular pathways, though the absolute lifetime risk remains low for most affected women.

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Abstract

OBJECTIVE: To critically evaluate the evidence linking endometriosis to ovarian cancer, with particular focus on endometrioid and clear cell histologic subtypes, and to inform risk stratification and patient counseling. METHODS: A systematic review, conducted according to PRISMA guidelines, was used to assess the association between endometriosis and ovarian cancer risk. Additional evidence on molecular, clinical, and therapeutic aspects was synthesized through a multidisciplinary narrative review informed by expert panel discussion. RESULTS: Epidemiological studies consistently demonstrate a modest but statistically significant increase in ovarian cancer risk among women with endometriosis, particularly for endometrioid and clear cell subtypes. Cohort studies report relative risks ranging from 1.3 to 4.2, with the highest estimates observed in women with ovarian endometriomas or deep infiltrating disease. Molecular analyses reveal shared alterations, including mutations in ARID1A, PIK3CA, and PTEN, alongside epigenetic changes and dysregulation of inflammatory and estrogen-dependent pathways, supporting a biological continuum between endometriotic lesions and malignant transformation. Nevertheless, the absolute lifetime risk of ovarian cancer in women with endometriosis remains low (generally <2-5%). Current evidence does not justify routine oncologic surveillance or prophylactic surgery solely based on the diagnosis of endometriosis. CONCLUSIONS: Endometriosis confers a slightly increased relative risk of specific ovarian cancer subtypes; however, the absolute risk remains low for most women, and this distinction is critical to avoid unnecessary anxiety, surveillance, or overtreatment. Individualized risk assessment and prospective studies integrating epidemiologic and molecular data are needed to refine stratification strategies and guide evidence-based care.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (68)

SciLite annotations

chemicals 1
estrogen

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