Impact of endometriosis on risk of ovarian, endometrial and cervical cancers: a meta-analysis

Abstract

Purpose

The risks of gynecologic cancer have not been well established in women with endometriosis. The objective of the present study was to investigate the influence of endometriosis on the risk for three gynecologic cancer (ovarian cancer, endometrial cancer and cervical cancer).

Methods

We gathered updated evidence about the risk relationship between endometriosis and gynecologic cancers by conducting a comprehensive search of several medical literature electronic databases, including PubMed, Embase and the Cochrane Library. The design and quality of all studies were evaluated using the Newcastle–Ottawa Scale (NOS), and a random-effects model was used to calculate pooled risk ratio (RR).

Results

Of the 8538 articles our search produced, we selected 25 qualified studies, including 16 cohort studies and 9 case–control studies. Patients with endometriosis had both an increased risk of ovarian cancer [RR  1.964; 95% CI (1.685, 2.290)]. The risk of endometrial cancer (EC) is not necessarily higher in patients with endometriosis [RR 1.176, 95% CI (0.878, 1.575)]. Endometriosis was not associated with an increased risk for cervical cancer (CC) [RR 0.670, 95% CI (0.537, 0.838)].

Conclusions

Patients with endometriosis need to be closely observed and rechecked regularly to prevent malignant changes.

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Acknowledgements

Thanks to all authors who contributed to this article.

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Contributions

Jia Li: select topic, literature search, data extraction and analysis, write the original article. Ruijuan Liu: select topic, literature search, data extraction and analysis, write of the review and editing. Shifeng Tang: data extraction, methodology. Fubin Feng: methodology. Cun Liu: the use of software, statistical analysis. Lu Wang: the use of software, statistical analysis. Wenge Zhao: validate the results, write the original article. Tingting Zhang: write, review, and edit the original article. Yan Yao: write the original article. Xue Wang: literature search. Changgang Sun: select topic, review original article.

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Correspondence to Changgang Sun.

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li, J., Liu, R., Tang, S. et al. Impact of endometriosis on risk of ovarian, endometrial and cervical cancers: a meta-analysis. Arch Gynecol Obstet 299, 35–46 (2019). https://doi.org/10.1007/s00404-018-4968-1

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Keywords

  • Endometriosis
  • Ovarian cancer
  • Endometrial cancer
  • Cervical cancer
  • Gynecological cancer
  • Risk