ENDOMETRIOSIS has previously been linked to an increased risk of ovarian cancer, however, the connection between disease subtypes and certain histotypes of ovarian cancer has not been thoroughly explored.
Researchers at Huntsman Cancer Institute at the University of Utah (the U), USA the Spencer Fox Eccles School of Medicine at the U, USA and Boston University Chobanian & Avedisian School of Medicine, Massachusetts, USA conducted a population-based cohort study on data from the Utah Population Database.
The study matched 78,893 female patients with endometriosis in a 1:5 ratio to women without endometriosis. The average age of the first endometriosis diagnosis was 36 years and, of the entire cohort, there were 597 patients with ovarian cancer.
The results showed the risk of ovarian cancer was higher among patients with endometriosis compared to healthy controls. This association was observed particularly in those patients with type I (endometrioid, clear cell, mucinous, and low-grade serous) rather than type II (high-grade serous) ovarian cancers.
The highest risk was seen in women with deep infiltrating endometriosis and ovarian endometriomas for all ovarian cancers. Their data suggested that patients with any level of diagnosed endometriosis had a 7-fold increased risk of developing type I ovarian cancer whilst, in patients with severe endometriosis the risk is increased 19-fold.
These findings are significant for clinical care, considering ovarian cancer has a five-year survival rate of 50%. The study suggests that women with severe endometriosis could benefit from being counselled about their elevated risk of ovarian cancer and potential preventive measures. Additionally, emphasis was placed on the importance of informing women about their risks to help them make informed decisions about their treatment options. While surgeries like hysterectomy or ovary removal might reduce cancer risk, more research is needed to determine the most effective preventative measures.
Katie Wright, EMJ
Reference
Barnard ME et al. Endometriosis typology and ovarian cancer risk. JAMA. 2024;DOI:10.1001/jama.2024.9210.
