Endometriosis linked to increased risk of cancer and endometrial hyperplasia

KOREA: According to a study that was published in Gynecologic Oncology, women with endometriosis had a much-increased chance of developing endometrial hyperplasia and endometrial cancer.

It is unknown how likely it is that someone with endometriosis may experience endometrial hyperplasia. Furthermore, it is unknown if endometriosis increases the risk of endometrial cancer.

After correcting for confounders, this population-based study conducted across the country looked at the relationships between endometrial hyperplasia and endometrial cancer and endometriosis.

In this study, data from the Korean National Health Insurance (NHI) database, which included 147,869 women with endometriosis diagnoses from 2002 to 2017, were evaluated. Each patient was matched to 20 control women who did not have endometriosis. The hazard ratios (HRs) of endometrial hyperplasia, endometrial cancer, and mortality from endometrial cancer were calculated using Cox proportional hazard regression models.

Over the course of 19,931,794 person-years of follow-up, 16,377 women were diagnosed with endometrial hyperplasia and 1795 with endometrial cancer among the three million women in this group.

Conclusive points:

• Endometrial cancer (aHR, 1.35; 95% CI, 1.12-1.63) and endometrial hyperplasia (aHR, 1.85; 95% CI, 1.75-1.95) were also considerably more common in women with endometriosis compared to those without it.
• higher risks for endometrial hyperplasia and endometrial cancer were seen in:

-Women diagnosed with endometriosis before the age of 45 (aHR, 2.16; 95% CI, 2.02-2.30 and aHR, 1.56; 1.18-2.06).

-Women with a BMI 23 kg/m2 (aHR, 1.38; 95% CI, 1.03-1.85 and 2.14; 1.99-2.30).

-Women who first went through menarche before the age of 15 (aHR, 1.99; 95% CI, 1.84-2.15; and aHR, 1.43; 1.06-1.91).

• The survival of patients with endometrial cancer was unaffected by an endometriosis diagnosis.

The authors came to the conclusion that endometriosis had no impact on the overall survivability of women with endometrial cancer. Further long-term prospective trials with sufficient confounder control are required.

The results indicate that regular endometrial surveillance is necessary in endometriosis-affected women because it can lead to an earlier diagnosis and course of therapy for endometrial hyperplasia and endometrial cancer.

REFERENCE

Kim H, Kim HJ, Ahn HS. Does endometriosis increase the risks of endometrial hyperplasia and endometrial cancer? Gynecol Oncol. 2022 Nov 7:S0090-8258(22)00425-5. doi: 10.1016/j.ygyno.2022.06.021. Epub ahead of print. PMID: 36357191.