Risk Profiles for Endometriosis in Japanese Women: Results From a Repeated Survey of Self-Reports

Toshiyuki Yasui, Kunihiko Hayashi, Kazue Nagai, Hideki Mizunuma, Toshiro Kubota, Jung‐Su Lee, Shosuke Suzuki
In: Journal of Epidemiology · 2015 · vol. 25(3) , pp. 194–203 · doi:10.2188/jea.je20140124 · W2093547892
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Short menstrual cycles and smoking increased endometriosis risk in Japanese women, while older age correlated with adenomyosis, with infertility history modifying endometriosis risk.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This study examined risk profiles for endometriosis in a large population of Japanese women by mailing questionnaires to 1025 participants who self-reported endometriosis in the Japan Nurses’ Health Study, using imaging findings with and without surgical confirmation and separately categorizing adenomyosis. Women with surgically confirmed endometriosis and those with imaging-diagnosed endometriosis without surgery shared broadly similar risk profiles, with a short menstrual cycle at 18–22 years and cigarette smoking at 30 years associated with increased endometriosis risk. In contrast, older age was associated with adenomyosis risk, and in participants with infertility history a short menstrual cycle increased endometriosis risk in both groups while differences between surgically confirmed and imaging-only endometriosis were seen only among those without infertility. The paper’s limitation is that it relies on self-report to identify the initial population and uses non-uniform diagnostic pathways (imaging versus surgical confirmation), which the authors note as potentially affecting risk estimates. This paper is centrally about endometriosis in Japanese women—comparing risk factors across surgically confirmed and imaging-diagnosed endometriosis and distinguishing them from adenomyosis, including how infertility history modifies these profiles.

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Abstract

Background: The prevalence and risk factors for endometriosis may differ according to diagnosis methodologies, such as study populations and diagnostic accuracy. We examined risk profiles in imaging-diagnosed endometriosis with and without surgical confirmation in a large population of Japanese women, as well as the differences in risk profiles of endometriosis based on history of infertility.Methods: Questionnaires that included items on sites of endometriosis determined by imaging techniques and surgical procedure were mailed to 1025 women who self-reported endometriosis in a baseline survey of the Japan Nurses’ Health Study (n = 15 019).Results: Two hundred and ten women had surgically confirmed endometriosis (Group A), 120 had imaging-diagnosed endometriosis without a surgical procedure (Group B), and 264 had adenomyosis (Group C). A short menstrual cycle at 18–22 years of age and cigarette smoking at 30 years of age were associated with significantly increased risk of endometriosis (Group A plus Group B), while older age was associated with risk of adenomyosis (Group C). In women with a history of infertility, a short menstrual cycle was associated with a significantly increased risk of endometriosis in both Group A and Group B, but risk profiles of endometriosis were different between Group A and Group B in women without a history of infertility.Conclusions: Women with surgically confirmed endometriosis and those with imaging-diagnosed endometriosis without surgery have basically common risk profiles, but these risk profiles are different from those with adenomyosis. The presence of a history of infertility should be taken into consideration for evaluation of risk profiles.
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Abstract

Background: The prevalence and risk factors for endometriosis may differ according to diagnosis methodologies, such as study populations and diagnostic accuracy. We examined risk profiles in imaging-diagnosed endometriosis with and without surgical confirmation in a large population of Japanese women, as well as the differences in risk profiles of endometriosis based on history of infertility.

Methods

Questionnaires that included items on sites of endometriosis determined by imaging techniques and surgical procedure were mailed to 1025 women who self-reported endometriosis in a baseline survey of the Japan Nurses’ Health Study (n = 15 019).

Results

Two hundred and ten women had surgically confirmed endometriosis (Group A), 120 had imaging-diagnosed endometriosis without a surgical procedure (Group B), and 264 had adenomyosis (Group C). A short menstrual cycle at 18–22 years of age and cigarette smoking at 30 years of age were associated with significantly increased risk of endometriosis (Group A plus Group B), while older age was associated with risk of adenomyosis (Group C). In women with a history of infertility, a short menstrual cycle was associated with a significantly increased risk of endometriosis in both Group A and Group B, but risk profiles of endometriosis were different between Group A and Group B in women without a history of infertility.

Conclusions

Women with surgically confirmed endometriosis and those with imaging-diagnosed endometriosis without surgery have basically common risk profiles, but these risk profiles are different from those with adenomyosis. The presence of a history of infertility should be taken into consideration for evaluation of risk profiles.

Methods

Questionnaires that included items on sites of endometriosis determined by imaging techniques and surgical procedure were mailed to 1025 women who self-reported endometriosis in a baseline survey of the Japan Nurses’ Health Study (n = 15 019).

Results

Two hundred and ten women had surgically confirmed endometriosis (Group A), 120 had imaging-diagnosed endometriosis without a surgical procedure (Group B), and 264 had adenomyosis (Group C). A short menstrual cycle at 18–22 years of age and cigarette smoking at 30 years of age were associated with significantly increased risk of endometriosis (Group A plus Group B), while older age was associated with risk of adenomyosis (Group C). In women with a history of infertility, a short menstrual cycle was associated with a significantly increased risk of endometriosis in both Group A and Group B, but risk profiles of endometriosis were different between Group A and Group B in women without a history of infertility.

Conclusions

Women with surgically confirmed endometriosis and those with imaging-diagnosed endometriosis without surgery have basically common risk profiles, but these risk profiles are different from those with adenomyosis. The presence of a history of infertility should be taken into consideration for evaluation of risk profiles. © 2015 Toshiyuki Yasui et al. This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Favorites & Alerts Recently viewed articles

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endometriosisadenomyosisinfertility

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