Increased incidence of ovarian cancer in both endometriosis and adenomyosis

Marjolein Hermens, van Altena AM, Anne M. van Altena, Bulten J, Johan Bulten, van Vliet HAAM, Huib A. A. M. van Vliet, Siebers AG, Albert G. Siebers, Ruud L M Bekkers
Gynecologic Oncology · 2021 · vol. 162(3) , pp. 735–740 · doi:10.1016/j.ygyno.2021.07.006 · PMID:34266690 · W3182325149
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This paper investigated the incidence of ovarian cancer in women with endometriosis and adenomyosis, finding an increased rate in both conditions.

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Abstract

ObjectiveAssessing the association between endometriosis and/or adenomyosis and ovarian cancer.MethodsWe identified all women with histological proven endometriosis (51,544 women) and/or adenomyosis (85,015 women) from the Dutch pathology database (1990-2015) and matched with women with a benign dermal nevus (132,654 women). Histology results for ovarian cancer were retrieved. We estimated crude and age-adjusted incidence rate ratios (IRR) for ovarian cancer.ResultsWe found 1017 (2.0%), 1284 (1.5%) and 471 (0.4%) ovarian cancer cases in the endometriosis, adenomyosis and nevus cohort, respectively. The age-adjusted IRRs were 19.75 (95% CI 16.70-23.35) in the endometriosis cohort and 5.93 (95% CI 4.91-7.16) in the adenomyosis cohort. The highest IRRs were found for endometrioid and clear cell ovarian cancer subtypes. Excluding the first year of follow-up did not result in a significant IRR for ovarian cancer overall but resulted in a statistically significant age-adjusted IRR of 3.92 (95% CI 2.19-7.01) for clear cell ovarian cancer and 2.39 (95% CI 1.28-4.45) for endometrioid ovarian cancer in the endometriosis cohort. Additionally, we found a statistically significant age-adjusted IRR of 2.51 (95% CI 1.29-4.90) for endometrioid ovarian cancer in the adenomyosis cohort.ConclusionWe found an increased ovarian cancer incidence in both histological proven endometriosis and adenomyosis. This increased incidence was largest for endometriosis. Excluding the first year of follow-up resulted in an increased incidence for endometrioid ovarian cancer in both cohorts and clear cell ovarian cancer in the endometriosis cohort. This study shows that gynecologist should also be aware of an increased ovarian cancer incidence in women with adenomyosis.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Adenomyosis Carcinoma, Ovarian Epithelial Endometriosis Ovarian Neoplasms Adenomyosis Adult Carcinoma, Ovarian Epithelial Cohort Studies Endometriosis Female Humans Incidence Middle Aged Netherlands Netherlands Ovarian Neoplasms Registries Risk Assessment

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License: CC0 · commercial use OK