Endometriosis as a risk factor for Ovarian or Endometrial Cancer – Results of a hospital based case control study

Stefan P. Renner, Stefanie Burghaus, Lothar Häberle, Katharina Heusinger, S. Hautmann, FC Thiel, Alexander Hein, D. Wachter, Arndt Hartmann, PA Fasching, M.W. Beckmann
In: Geburtshilfe und Frauenheilkunde · 2014 · vol. 74(S 01) · doi:10.1055/s-0034-1388578 · W2329376230
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This hospital-based case-control study investigated endometriosis as a potential risk factor for ovarian and endometrial cancer.

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This hospital-based case-control study evaluated whether endometriosis is associated with endometrial or ovarian cancer, using 289 cancer cases recruited from risk-assessment studies and 1016 controls recruited by newspaper advertisement. Logistic regression models identified prior oral contraceptive use as inversely associated with cancer status and found that endometriosis was more common among cases than controls, with an odds ratio of 2.53 (95% CI 1.23–5.21). The model including endometriosis had a slightly better fit than the model without it (AUC 0.67 vs 0.66; likelihood ratio test p=0.01). The paper notes that clinical prediction-model implementation would require a precise characterization of endometriosis. This paper is centrally about endometriosis — it tests endometriosis as a risk factor for ovarian or endometrial cancer.

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Abstract

Background: There is no screening program for ovarian or endometrial cancer. One way to address the problem could be the utilization of risk factors to define sub-populations with a higher incidence. Recently, there were hints that endometriosis could be a risk factor for ovarian cancer.
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Background

There is no screening program for ovarian or endometrial cancer. One way to address the problem could be the utilization of risk factors to define sub-populations with a higher incidence. Recently, there were hints that endometriosis could be a risk factor for ovarian cancer.

Methods

We conducted a hospital based case control analysis. Cases were patients with endometrial or ovarian cancer who participated in studies aiming at risk assessment for these diseases. Controls were women who were invited by newspaper advertisement. A total of 289 cases and 1016 controls were included. Two logistic regression models were used, one with the predictors age, number of pregnancies and previous oral contraceptive (OC) use and another one including additionally whether the patient was diagnosed with endometriosis.

Results

Endometriosis was present in 21 controls (2.1%) and 14 cases (4.8%). Relevant predictors for case control status were previous OC use (OR = 0.41; 95% CI: 0.30 – 0.55) and endometriosis (OR = 2.53; 95% CI: 1.23 – 5.21). The prediction model that included endometriosis was slightly better (p = 0.01, likelihood ratio test) than the model without endometriosis (AUC = 0.67 vs. AUC = 0.66).

Conclusion

In our case control study endometriosis could be described as a risk factor for endometrial or ovarian cancer. Studies addressing this question are rare and the implementation into a clinical prediction model would demand a precise characterization of the risk factor endometriosis. For this purpose we initiated a multicentric cohort study (www.myendometriosis.org), the International Endometriosis Evaluation Program where centers all over the world are invited to participate.

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endometriosis

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