Risk factors of epithelial ovarian carcinomas among women with endometriosis: a systematic review

Line Holdgaard Thomsen, Line H Thomsen, Tine Henrichsen Schnack, Kristina Buchardi, Lone Hummelshoj, Lone Hummelshøj, Stacey A Missmer, Axel Forman, Jan Blaakær
Acta obstetricia et gynecologica Scandinavica · 2016 · vol. 96(6) , pp. 761–778 · doi:10.1111/aogs.13010 · PMID:27565819 · W2510500774
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This systematic review identified factors associated with epithelial ovarian cancer risk in women with endometriosis, including surgical excision and oral contraceptive use (lower risk) and older age, nulliparity, and endometrioma size (higher risk).

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Abstract

INTRODUCTION: The objective of this review was to evaluate the published literature on epidemiologic risk factors for epithelial ovarian cancer among women with a diagnosis of endometriosis. MATERIAL AND METHODS: A systematic literature search was conducted in PubMed and Scopus. Studies comparing epidemiologic risk factors of epithelial ovarian cancer among women with endometriosis were included. A quality assessment was conducted using the Newcastle-Ottawa Scale. RESULTS: Eight of 794 articles met the inclusion criteria. A lower risk of epithelial ovarian cancer was observed in women with documented complete surgical excision of endometriotic tissue and suggested among women with unilateral oophorectomy. The use of oral contraceptives (≥10 years) may be associated with a lower risk of epithelial ovarian cancer among women with endometriosis, whereas older age at endometriosis diagnosis (≥45 years, pre- or postmenopausal), nulliparity, hyperestrogenism (endogenous or exogenous), premenopausal status at endometriosis diagnosis, solid compartments as well as larger size of endometrioma (≥9 cm in diameter at endometriosis diagnosis) were all associated with an increased risk of ovarian cancer. CONCLUSIONS: A subgroup of women with endometriosis characterized by endometriosis observed through surgery or imaging after the age of 45 years, nulliparity, postmenopausal status at endometriosis diagnosis, larger size of endometrioma (>9 cm) at endometriosis diagnosis, hyperestrogenism (endogenous or exogenous) and/or cysts with solid compartments may have an elevated risk of epithelial ovarian cancer. However, due to the limited number and size of studies in this area we cannot draw definitive conclusions. Further research into a risk factor profile among women with endometriosis is needed before clear recommendations can be made.

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Condition tags

mesh:D004715endometriosisendometrioma

MeSH descriptors

Endometriosis Neoplasms, Glandular and Epithelial Neoplasms, Glandular and Epithelial Ovarian Neoplasms Ovarian Neoplasms Carcinoma, Ovarian Epithelial Endometriosis Female Humans Neoplasms, Glandular and Epithelial Ovarian Neoplasms Risk Factors Women's Health

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (94)

Cited by (50)

Source provenance

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