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Published in: Archives of Gynecology and Obstetrics 1/2019

01-01-2019 | Review

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

Authors: Jia li, Ruijuan Liu, Shifeng Tang, Fubin Feng, Cun Liu, Lu Wang, Wenge Zhao, Tingting Zhang, Yan Yao, Xue Wang, Changgang Sun

Published in: Archives of Gynecology and Obstetrics | Issue 1/2019

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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.
Appendix
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Literature
1.
go back to reference Garry Md Frcog R (2001) Endometriosis an invasive disease. Gynecol Endosc 10:79–82CrossRef Garry Md Frcog R (2001) Endometriosis an invasive disease. Gynecol Endosc 10:79–82CrossRef
3.
go back to reference Re S (1987) Classification of human ovarian tumors.pdf. Environ Health Perspect 73:15–25CrossRef Re S (1987) Classification of human ovarian tumors.pdf. Environ Health Perspect 73:15–25CrossRef
6.
go back to reference Baldi A, Campioni M, Signorile PG (2008) Endometriosis: pathogenesis, diagnosis, therapy and association with cancer (review). Oncol Rep 19:843–846PubMed Baldi A, Campioni M, Signorile PG (2008) Endometriosis: pathogenesis, diagnosis, therapy and association with cancer (review). Oncol Rep 19:843–846PubMed
7.
go back to reference Ness RB, Cramer DW, Goodman MT, Kjaer SK, Mallin K, Mosgaard BJ, Purdie DM, Risch HA, Vergona R, Wu AH (2002) Infertility, fertility drugs, and ovarian cancer: a pooled analysis of case-control studies. Am J Epidemiol 155:217–224CrossRef Ness RB, Cramer DW, Goodman MT, Kjaer SK, Mallin K, Mosgaard BJ, Purdie DM, Risch HA, Vergona R, Wu AH (2002) Infertility, fertility drugs, and ovarian cancer: a pooled analysis of case-control studies. Am J Epidemiol 155:217–224CrossRef
17.
go back to reference Lo CKM, Loeb M (2014) Newcastle-Ottawa scale_Comparing reviewers’ to authors’ assessments.pdf. BMC Med Res Methodol 14:45CrossRef Lo CKM, Loeb M (2014) Newcastle-Ottawa scale_Comparing reviewers’ to authors’ assessments.pdf. BMC Med Res Methodol 14:45CrossRef
20.
go back to reference Adami HO, Hunter DJ, Trichopoulos D (2002) Textbook of cancer epidemiology.pdf. Epidemiology 15:123 Adami HO, Hunter DJ, Trichopoulos D (2002) Textbook of cancer epidemiology.pdf. Epidemiology 15:123
21.
go back to reference Higgins JPTS, Deeks JJ, Altman DG (2003) Measuring inconsistency in metaanalyses.pdf. BMJ 327:557–560CrossRef Higgins JPTS, Deeks JJ, Altman DG (2003) Measuring inconsistency in metaanalyses.pdf. BMJ 327:557–560CrossRef
22.
go back to reference Wang KC, Chang WH, Lee WL, Huang N, Huang HY, Yen MS, Guo CY, Wang PH (2014) An increased risk of epithelial ovarian cancer in Taiwanese women with a new surgico-pathological diagnosis of endometriosis.pdf. BMC Cancer 14:831CrossRef Wang KC, Chang WH, Lee WL, Huang N, Huang HY, Yen MS, Guo CY, Wang PH (2014) An increased risk of epithelial ovarian cancer in Taiwanese women with a new surgico-pathological diagnosis of endometriosis.pdf. BMC Cancer 14:831CrossRef
28.
go back to reference Pearce CL, Templeman C, Rossing MA, Lee A, Near AM, Webb PM, Nagle CM, Doherty JA, Cushing-Haugen KL, Wicklund KG, Chang-Claude J, Hein R, Lurie G, Wilkens LR, Carney ME, Goodman MT, Moysich K, Kjaer SK, Hogdall E, Jensen A, Goode EL, Fridley BL, Larson MC, Schildkraut JM, Palmieri RT, Cramer DW, Terry KL, Vitonis AF, Titus LJ, Ziogas A, Brewster W, Anton-Culver H, Gentry-Maharaj A, Ramus SJ, Anderson AR, Brueggmann D, Fasching PA, Gayther SA, Huntsman DG, Menon U, Ness RB, Pike MC, Risch H, Wu AH, Berchuck A (2012) Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case–control studies. Lancet Oncol 13(4):385–394. https://doi.org/10.1016/s1470-2045(11)70404-1 CrossRefPubMedPubMedCentral Pearce CL, Templeman C, Rossing MA, Lee A, Near AM, Webb PM, Nagle CM, Doherty JA, Cushing-Haugen KL, Wicklund KG, Chang-Claude J, Hein R, Lurie G, Wilkens LR, Carney ME, Goodman MT, Moysich K, Kjaer SK, Hogdall E, Jensen A, Goode EL, Fridley BL, Larson MC, Schildkraut JM, Palmieri RT, Cramer DW, Terry KL, Vitonis AF, Titus LJ, Ziogas A, Brewster W, Anton-Culver H, Gentry-Maharaj A, Ramus SJ, Anderson AR, Brueggmann D, Fasching PA, Gayther SA, Huntsman DG, Menon U, Ness RB, Pike MC, Risch H, Wu AH, Berchuck A (2012) Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case–control studies. Lancet Oncol 13(4):385–394. https://​doi.​org/​10.​1016/​s1470-2045(11)70404-1 CrossRefPubMedPubMedCentral
31.
go back to reference Aris A (2010) Endometriosis-associated ovarian cancer: a ten-year cohort study of women living in the Estrie region of Quebec, Canada.pdf. Aris J Ovarian Res 3:1CrossRef Aris A (2010) Endometriosis-associated ovarian cancer: a ten-year cohort study of women living in the Estrie region of Quebec, Canada.pdf. Aris J Ovarian Res 3:1CrossRef
32.
go back to reference Brinton LA, Gridley G, Persson I, Baron J, Bergqvist A (1997) Cancer risk after a hospital discharge diagnosis of endometriosis.pdf. Am J Obstet Gynecol 176:572–579CrossRef Brinton LA, Gridley G, Persson I, Baron J, Bergqvist A (1997) Cancer risk after a hospital discharge diagnosis of endometriosis.pdf. Am J Obstet Gynecol 176:572–579CrossRef
35.
go back to reference Ness RB, Grisso JA, Cottreau C, Klapper J, Vergona R, Wheeler JE, Morgan M, Schlesselman JJ (2000) Factors related to inflammation of the ovarian epithelium and risk of ovarian cancer. Epidemiology. 11(2):111–117CrossRef Ness RB, Grisso JA, Cottreau C, Klapper J, Vergona R, Wheeler JE, Morgan M, Schlesselman JJ (2000) Factors related to inflammation of the ovarian epithelium and risk of ovarian cancer. Epidemiology. 11(2):111–117CrossRef
36.
go back to reference Olson JE, Cerhan JR, Janney CA, Anderson KE, Vachon CM, Sellers TA (2002) Postmenopausal cancer risk after self-reported endometriosis diagnosis in the Iowa Women’s Health Study. Cancer 94(5):1612–1618CrossRef Olson JE, Cerhan JR, Janney CA, Anderson KE, Vachon CM, Sellers TA (2002) Postmenopausal cancer risk after self-reported endometriosis diagnosis in the Iowa Women’s Health Study. Cancer 94(5):1612–1618CrossRef
40.
go back to reference Borgfeldt C, Andolf E (2004) Cancer risk after hospital discharge diagnosis of benign ovarian cysts and endometriosis.pdf. Acta Obstet Gynecol Scand 83:395–400CrossRef Borgfeldt C, Andolf E (2004) Cancer risk after hospital discharge diagnosis of benign ovarian cysts and endometriosis.pdf. Acta Obstet Gynecol Scand 83:395–400CrossRef
45.
go back to reference Kurman RJKP, Norris HJ (1985) The behavior of endometrial hyperplasia. A long-term study of “untreated” hyperplasia in 170 patients.pdf. Cancer Causes Control CCC 56:403–412 Kurman RJKP, Norris HJ (1985) The behavior of endometrial hyperplasia. A long-term study of “untreated” hyperplasia in 170 patients.pdf. Cancer Causes Control CCC 56:403–412
46.
go back to reference Jiang X, Bryan EJ (1996) Microsatellite analysis of endometriosis reveals loss of heterozygosity at candidate ovarian tumor suppressor gene loci.pdf. Cancer Res 56:3534–3539PubMed Jiang X, Bryan EJ (1996) Microsatellite analysis of endometriosis reveals loss of heterozygosity at candidate ovarian tumor suppressor gene loci.pdf. Cancer Res 56:3534–3539PubMed
47.
go back to reference Jiang X, Hitchcock A (1998) Allelotyping of endometriosis with adjacent ovarian carcinoma reveals evidence of a common lineage.pdf. Cancer Res 58:707–1712 Jiang X, Hitchcock A (1998) Allelotyping of endometriosis with adjacent ovarian carcinoma reveals evidence of a common lineage.pdf. Cancer Res 58:707–1712
50.
go back to reference Fishman A, Demirel D, Laucirica R, Ramzy I, Klima T, Lyzak J, Kaplan AL (1996) Malignant tumors arising in endometriosis: clinical-pathological study and flow cytometry analysis. Eur J Obstet Gynecol Reprod Biol. 70(1):69–74CrossRef Fishman A, Demirel D, Laucirica R, Ramzy I, Klima T, Lyzak J, Kaplan AL (1996) Malignant tumors arising in endometriosis: clinical-pathological study and flow cytometry analysis. Eur J Obstet Gynecol Reprod Biol. 70(1):69–74CrossRef
52.
53.
go back to reference Dinulescu DM, Ince TA, Quade BJ, Shafer SA, Crowley D, Jacks T (2005) Role of K-ras and Pten in the development of mouse models of endometriosis and endometrioid ovarian cancer.pdf. Nat Med. 11(1):63–70CrossRef Dinulescu DM, Ince TA, Quade BJ, Shafer SA, Crowley D, Jacks T (2005) Role of K-ras and Pten in the development of mouse models of endometriosis and endometrioid ovarian cancer.pdf. Nat Med. 11(1):63–70CrossRef
55.
go back to reference Baxter SW, Thomas EJ, Campbell IG (2001) GSTM1 null polymorphism and susceptibility to endometriosis and ovarian cancer.pdf. Carcinogenesis 22:63–65CrossRef Baxter SW, Thomas EJ, Campbell IG (2001) GSTM1 null polymorphism and susceptibility to endometriosis and ovarian cancer.pdf. Carcinogenesis 22:63–65CrossRef
57.
go back to reference Hayrabedyan S, Mourdjeva M, Kyurkchiev S, Kehayov I (2004) Immunofluorescent localization of Il-1α, FGF-1, S100A13 as angiogenic factors and a specific ovarian cancer marker (ovac) in endometriosis. Clin Appl Immunol. 3(1):310–315 Hayrabedyan S, Mourdjeva M, Kyurkchiev S, Kehayov I (2004) Immunofluorescent localization of Il-1α, FGF-1, S100A13 as angiogenic factors and a specific ovarian cancer marker (ovac) in endometriosis. Clin Appl Immunol. 3(1):310–315
59.
go back to reference Bulun S, Zeitoun K, Takayama K, Sasano H (2000) Estrogen biosynthesis in endometriosis: molecular basis and clinical relevance. J Mol Endocrinol 25(1):35–42CrossRef Bulun S, Zeitoun K, Takayama K, Sasano H (2000) Estrogen biosynthesis in endometriosis: molecular basis and clinical relevance. J Mol Endocrinol 25(1):35–42CrossRef
61.
go back to reference Tuynman JB, Hulscher JB, Steller EP, van Lanschot JJ, Richel DJ (2003) Cyclooxygenase (COX)-2-inhibition in the prevention and treatment of colorectal carcinoma. Ned Tijdschr Geneeskd 147(45):2207–2212PubMed Tuynman JB, Hulscher JB, Steller EP, van Lanschot JJ, Richel DJ (2003) Cyclooxygenase (COX)-2-inhibition in the prevention and treatment of colorectal carcinoma. Ned Tijdschr Geneeskd 147(45):2207–2212PubMed
Metadata
Title
Impact of endometriosis on risk of ovarian, endometrial and cervical cancers: a meta-analysis
Authors
Jia li
Ruijuan Liu
Shifeng Tang
Fubin Feng
Cun Liu
Lu Wang
Wenge Zhao
Tingting Zhang
Yan Yao
Xue Wang
Changgang Sun
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 1/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-018-4968-1

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