Abstract
Purpose
To examine the current mechanisms of the increased incidence of cancer in women with endometriosis.
Methods
The synthesis and review of the relevant current literature in English language.
Results
Compared with general population, women with endometriosis have two times higher risk for developing ovarian cancer, 30% higher risk for developing breast cancer, and 40% higher risk for developing hematopoietic malignancies, mainly non-Hodgkin lymphoma.
Conclusions
Endometriosis comprises many predisposing factors including genetic, epigenetic, local environmental, hormonal, inflammatory and immunologic changes, for the development of some cancers.
Similar content being viewed by others
References
Hudelist G, Keckstein J, Wright JT (2009) The migrating adenomyoma: past views on the etiology of adenomyosis and endometriosis. Fertil Steril 92:1536–1543
Tariverdian N, Theoharides TC, Siedentopf F et al (2007) Neuroendocrine–immune disequilibrium and endometriosis: an interdisciplinary approach. Semin Immunopathol 29:193–210
Karanjgaokar VC, Murphy DJ, Samra JS, Mann CH (2009) Malignant transformation of residual endometriosis after hysterectomy: a case series. Fertil Steril 92:2037.e19-21
Vlahos NF, Kalampokas T, Fotiou S (2010) Endometriosis and ovarian cancer: a review. Gynecol Endocrinol 26:213–219
Kauppila S, Altinörs M, Väre P, Liakka A, Knuuti E, Nissi R (2008) Primary sex cord-like variant of endometrioid adenocarcinoma arising from endometriosis. APMIS 116:842–845
Efthymiou CA (2009) Endometriosis-associated intestinal tumours: a consequence of long-term unopposed oestrogen? Ann R Coll Surg Engl 91:259–260
Manipadam MT, Munemane A, Emmanuel P, McCluggage WG (2008) Ovarian adenosarcoma with extensive deciduoid morphology arising in endometriosis: a case report. Int J Gynecol Pathol 27:398–401
Nagle CM, Olsen CM, Webb PM, Jordan SJ, Whiteman DC, Green AC (2008) Endometrioid and clear cell ovarian cancers: a comparative analysis of risk factors. Eur J Cancer 44:2477–2484
Orezzoli JP, Russell AH, Oliva E, Del Carmen MG, Eichhorn J, Fuller AF (2008) Prognostic implication of endometriosis in clear cell carcinoma of the ovary. Gynecol Oncol 110:336–344
Park HM, Lee SS, Eom DW, Kang GH, Yi SW, Sohn WS (2009) Endometrioid adenocarcinoma arising from endometriosis of the uterine cervix: a case report. J Korean Med Sci 24:767–771
Vlahos NF, Economopoulos KP, Fotiou S (2010) Endometriosis, in vitro fertilisation and the risk of gynaecological malignancies, including ovarian and breast cancer. Best Pract Res Clin Obstet Gynaecol 24:39–50
Sznurkowski JJ, Emerich J (2008) Endometriomas are more frequent on the left side. Acta Obstet Gynecol Scand 87:104–106
Nezhat F, Datta MS, Hanson V, Pejovic T, Nezhat C, Nezhat C (2008) The relationship of endometriosis and ovarian malignancy: a review. Fertil Steril 90:1559–1570
Brinton LA, Gridley G, Persson I, Baron J, Bergqvist A (1997) Cancer risk after a hospital discharge diagnosis of endometriosis. Am J Obstet Gynecol 176:572–579
Matalliotakis I, Cakmak H, Fragouli Y, Zervoudis S, Neonaki M, Arici A (2009) Association of endometriosis with family history of non-Hodgkin’s lymphoma: presentation of 10 cases. J BUON 14:699–701
Aris A (2010) Endometriosis-associated ovarian cancer: a ten-year cohort study of women living in the Estrie Region of Quebec, Canada. J Ovarian Res 3:2
Agrawal A, Nation J, Ghatage P, Chu P, Ross S, Magliocco A (2009) Malignant chest wall endometriosis: a case report and literature review. J Obstet Gynaecol Can 31:538–541
Benoit L, Arnould L, Cheynel N et al (2006) Malignant extraovarian endometriosis: a review. Eur J Surg Oncol 32:6–11
Wu WC, Hsiao MW, Ye JC, Hung YC, Chang WC (2009) Malignant transformation of extragonadal endometriosis: a case report. Eur J Gynaecol Oncol 30:563–565
Hiromura T, Tanaka YO, Nishioka T, Satoh M, Tomita K (2009) Clear cell adenocarcinoma of the uterine cervix arising from a background of cervical endometriosis. Br J Radiol 82:e20–e22
Bertelsen L, Mellemkjaer L, Frederiksen K et al (2007) Risk for breast cancer among women with endometriosis. Int J Cancer 120:1372–1375
Matalliotakis IM, Cakmak H, Mahutte N, Goumenou AG, Koumantakis G, Arici A (2008) The familial risk of breast cancer in women with endometriosis from Yale series. Surg Oncol 17:289–293
Matsuo K, Alonsozana EL, Eno ML, Rosenshein NB, Im DD (2009) Primary peritoneal clear cell adenocarcinoma arising in previous abdominal scar for endometriosis surgery. Arch Gynecol Obstet 280:637–641
Kobayashi S, Sasaki M, Goto T et al (2010) Endometrioid adenocarcinoma arising from endometriosis of the rectosigmoid. Dig Endosc 22:59–63
Staats PN, Clement PB, Young RH (2007) Primary endometrioid adenocarcinoma of the vagina: a clinicopathologic study of 18 cases. Am J Surg Pathol 31:1490–1501
Peiretti M, Zakashansky K, Melis GB, Mais V (2008) Unusual case of adenocarcinoma arising in endometriosis mimicking colorectal cancer in a young woman with a Müllerian anomaly. Fertil Steril 90:199.e13–5
Swiersz LM (2002) Role of endometriosis in cancer and tumor development. Ann NY Acad Sci 955:281–292
Boruban MC, Jaishuen A, Sirisabya N et al (2008) Ovarian endometriosis associated with carcinoma and sarcoma: case report. Eur J Gynaecol Oncol 29:393–396
Oppelt P, Renner SP, Strick R et al (2010) Correlation of high-risk human papilloma viruses but not of herpes viruses or Chlamydia trachomatis with endometriosis lesions. Fertil Steril 93:1778–1786
Ali-Fehmi R, Khalifeh I, Bandyopadhyay S et al (2006) Patterns of loss of heterozygosity at 10q23.3 and microsatellite instability in endometriosis, atypical endometriosis, and ovarian carcinoma arising in association with endometriosis. Int J Gynecol Pathol 25:223–229
Borghese B, Mondon F, Noël JC et al (2008) Gene expression profile for ectopic versus eutopic endometrium provides new insights into endometriosis oncogenic potential. Mol Endocrinol 22:2557–2562
Mandai M, Yamaguchi K, Matsumura N, Baba T, Konishi I (2009) Ovarian cancer in endometriosis: molecular biology, pathology, and clinical management. Int J Clin Oncol 14:383–391
Götte M, Wolf M, Staebler A et al (2008) Increased expression of the adult stem cell marker Musashi-1 in endometriosis and endometrial carcinoma. J Pathol 215:317–329
Guo SW (2009) Epigenetics of endometriosis. Mol Hum Reprod 15:587–607
Kondi-Paphitis A, Smyrniotis B, Liapis A, Kontoyanni A, Deligeorgi H (1998) Stromal sarcoma arising on endometriosis. A clinicopathological and immunohistochemical study of 4 cases. Eur J Gynaecol Oncol 19:588–590
Kobayashi H, Yamada Y, Kanayama S et al (2009) The role of iron in the pathogenesis of endometriosis. Gynecol Endocrinol 25:39–52
Yap OW, Bhat G, Liu L, Tollefsbol TO (2009) Epigenetic modifications of the estrogen receptor β gene in epithelial ovarian cancer cells. Anticancer Res 29:139–144
Karita M, Yamashita Y, Hayashi A, et al. (2011) Does advanced-stage endometriosis affect the gene expression of estrogen and progesterone receptors in granulosa cells? Fertil Steril 95:889–894
Bulun SE, Cheng YH, Yin P et al (2006) Progesterone resistance in endometriosis: link to failure to metabolize estradiol. Mol Cell Endocrinol 248:94–103
Govindan S, Ahmad SN, Vedicherla B et al (2007) Association of progesterone receptor gene polymorphism (PROGINS) with endometriosis, uterine fibroids and breast cancer. Cancer Biomark 3:73–78
Grammatikakis I, Zervoudis S, Evangelinakis N, Tziortzioti V (2010) Endometrium and ovarian cancer synchronous to endometriosis—a retrospective study of our experience of 7 years. J Med Life 3:76–79
Kondi-Pafiti A, Grapsa D, Liapis A, Papadias K, Kairi-Vassilatou E, Hasiakos D (2008) Synchronous ovarian and endometrial carcinoma: a strong link to endometriosis? Eur J Gynaecol Oncol 29:256–259
Vaissière T, Sawan C, Herceg Z (2008) Epigenetic interplay between histone modifications and DNA methylation in gene silencing. Mutat Res 659:40–48
Takemura Y, Osuga Y, Harada M et al (2005) Serum adiponectin concentrations are decreased in women with endometriosis. Hum Reprod 20:3510–3513
Beebe-Dimmer JL, Zuhlke KA, Ray AM, Lange EM, Cooney KA (2010) Genetic variation in adiponectin (ADIPOQ) and the type 1 receptor (ADIPOR1), obesity and prostate cancer in African Americans. Prostate Cancer Prostatic Dis 13:362–368
Massuger L, Roelofsen T, Ham M, Bulten J (2010) The origin of serous ovarian cancer may be found in the uterus: a novel hypothesis. Med Hypotheses 74:859–861
Depalo R, Cavallini A, Lorusso F et al (2009) Apoptosis in normal ovaries of women with and without endometriosis. Reprod Biomed Online 19:808–815
Hirabayashi K, Yasuda M, Kajiwara H et al (2009) Clear cell adenocarcinoma arising from adenomyosis. Int J Gynecol Pathol 28:262–266
Mhawech P, Kinkel K, Vlastos G, Pelte MF (2002) Ovarian carcinomas in endometriosis: an immunohistochemical and comparative genomic hybridization study. Int J Gynecol Pathol 21:401–406
Barros SP, Offenbacher S (2009) Epigenetics: connecting environment and genotype to phenotype and disease. J Dent Res 88:400–408
Van Patten K, Parkash V, Jain D (2010) Cadherin expression in gastrointestinal tract endometriosis: possible role in deep tissue invasion and development of malignancy. Mod Pathol 23:38–44
Shaco-Levy R, Sharabi S, Benharroch D, Piura B, Sion-Vardy N (2008) Matrix metalloproteinases 2 and 9, E-cadherin, and beta-catenin expression in endometriosis, low-grade endometrial carcinoma and non-neoplastic eutopic endometrium. Eur J Obstet Gynecol Reprod Biol 139:226–232
Nyiraneza C, Marbaix E, Smets M, Galant C, Sempoux C, Dahan K (2010) High risk for neoplastic transformation of endometriosis in a carrier of Lynch syndrome. Fam Cancer 9:383–387
Kobayashi H, Kajiwara H, Kanayama S et al (2009) Molecular pathogenesis of endometriosis-associated clear cell carcinoma of the ovary (review). Oncol Rep 22:233–240
Konishi I (2009) Ovarian cancer in endometriosis. Int J Clin Oncol 14:377
Keita M, Bessette P, Pelmus M, Ainmelk Y, Aris A (2010) Expression of interleukin-1 (IL-1) ligands system in the most common endometriosis-associated ovarian cancer subtypes. J Ovarian Res 3:3
Wilson AG (2008) Epigenetic regulation of gene expression in the inflammatory response and relevance to common diseases. J Periodontol 79:1514–1519
Mach P, Blecharz P, Basta P et al (2010) Differences in the soluble HLA-G blood serum concentration levels in patients with ovarian cancer and ovarian and deep endometriosis. Am J Reprod Immunol 63:387–395
Gemmill JA, Stratton P, Cleary SD, Ballweg ML, Sinaii N (2010) Cancers, infections, and endocrine diseases in women with endometriosis. Fertil Steril 94:1627–1631
Khan KN, Kitajima M, Hiraki K et al (2008) Immunopathogenesis of pelvic endometriosis: role of hepatocyte growth factor, macrophages and ovarian steroids. Am J Reprod Immunol 60:383–404
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kokcu, A. Relationship between endometriosis and cancer from current perspective. Arch Gynecol Obstet 284, 1473–1479 (2011). https://doi.org/10.1007/s00404-011-2047-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-011-2047-y