Bias versus causality: interpreting recent evidence of association between endometriosis and ovarian cancer

Paola Viganò, Edgardo Somigliana, Fabio Parazzini, Paolo Vercellini
Fertility and sterility · 2007 · vol. 88(3) , pp. 588–593 · doi:10.1016/j.fertnstert.2006.11.180 · PMID:17320873 · W2066109414
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This paper discusses the challenges of distinguishing bias from causality when interpreting associations between endometriosis and ovarian cancer, highlighting the need for careful analysis of recent evidence.

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Abstract

ObjectiveTo establish whether causality versus biases may explain the association of endometriosis and ovarian cancer.DesignWe employ the nine criteria proposed by Austin Bradford Hill, which still stand as foundation milestones for causal inference.SettingUniversity-based clinic.Patient(s)None.Intervention(s)Search strategies included online searching of the MEDLINE database and hand searching of relevant publications and reviews. Additional reports were collected by systematically reviewing all references from retrieved papers.Main outcome measure(s)Examination of the causal relationship between endometriosis and ovarian cancer.Result(s)Based on the present analysis, the criterion of strength has not been fulfilled. There were insufficient or mixed data for four criteria (biological gradient, biological plausibility, analogy, coherence), and four criteria were fulfilled (consistency, temporality, specificity, experimental evidence in animal model).Conclusion(s)A causal relationship between endometriosis and specific histotypes of ovarian cancer should be recognized, but the low magnitude of the risk observed is consistent with the view that ectopic endometrium undergoes malignant transformation with a frequency similar to its eutopic counterpart.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Ovarian Neoplasms Case-Control Studies Cohort Studies Endometriosis Female Humans Observer Variation Ovarian Neoplasms Patient Selection Probability Reproducibility of Results Risk Factors

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.

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Cited by (46)

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