Endometriosis and ovarian cancer: potential benefits and harms of screening and risk-reducing surgery

Sun-Wei Guo, Sun‐Wei Guo
Fertility and sterility · 2015 · vol. 104(4) , pp. 813–830 · doi:10.1016/j.fertnstert.2015.08.006 · PMID:26335131 · W1961765983
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This paper examines the potential benefits and harms of screening and risk-reducing surgery for individuals with endometriosis in relation to ovarian cancer.

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Abstract

Although endometriosis is well recognized as a benign gynecologic condition, its association with ovarian cancer (OVCA) has frequently been reported. Review articles on this topic are voluminous, yet there seems to be no consensus as to whether endometriosis is truly a precursor of OVCA and whether any screening or risk-reducing surgery should be instituted, on the basis of our current knowledge. In this review, published data are compiled and critically appraised. Through this critical appraisal, it seems clear that the strongest evidence seems to come from prevalence data. This type of data also suggests a reduced risk of certain histotypes (mainly type II) of OVCA in women with endometriosis. This may explain the rather moderate increase in risk as shown in epidemiologic studies. Even with this moderate increase in OVCA risk, caution should be exercised because of apparent bias in favor of publication of positive results, extensive heterogeneities among prevalence estimates, and inverse relationship between estimates and sizes of the studies. Many molecular studies are conflicting, and earlier studies showing molecular aberrations involved in genomic instability and mutation that enable malignant transformation are not replicated in later studies. Given the low incidence of OVCA and the rather moderate increase in risk of mostly type I tumors, screening seems to be ill-advised, and risk-reducing surgery such as salpingectomy with or without oophorectomy does not seem to yield any substantial benefit to women with endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Gynecologic Surgical Procedures Gynecologic Surgical Procedures Ovarian Neoplasms Case-Control Studies Cohort Studies Endometriosis Endometriosis Endometriosis Female Humans Mass Screening Mass Screening Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Prevalence Risk Assessment

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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 (100)

Cited by (50)

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