The authors have stated explicitly that there are no conflicts of interest in connection with this article.
The relation between endometriosis and ovarian cancer – a review
Article first published online: 9 OCT 2013
© 2013 Nordic Federation of Societies of Obstetrics and Gynecology
Acta Obstetricia et Gynecologica Scandinavica
Volume 93, Issue 1, pages 20–31, January 2014
How to Cite
The relation between endometriosis and ovarian cancer – a review. Acta Obstet Gynecol Scand 2014; 93:20–31., , , .
- Issue published online: 17 DEC 2013
- Article first published online: 9 OCT 2013
- Accepted manuscript online: 6 SEP 2013 09:15AM EST
- Manuscript Accepted: 30 AUG 2013
- Manuscript Received: 15 JAN 2012
- ovarian cancer;
Endometriosis is known to harbor characteristics substantiating its possible role as a precursor of ovarian cancer.
To assess the quality of the literature regarding the association between endometriosis and ovarian cancer and to estimate the extent of this relation.
An electronic literature search was conducted in PubMed and 1112 articles dealing with the relation between endometriosis and ovarian cancer were identified. Original articles based on case-control studies, cohort studies and cross-sectional studies were included. Studies consisting of populations with self-reported endometriosis were excluded, as were articles with fewer than 20 cases of ovarian cancer. Twenty-eight studies underwent detailed quality assessments based on the checklists developed by the Scottish Intercollegiate Guidelines Network (SIGN). Meta-analyses were conducted on selected subgroups of ovarian cancer with coexisting endometriosis.
None of the 28 studies was given the highest possible rating using the SIGN checklists. The risk of ovarian cancer in women with endometriosis was reported to be a standardized incidence ratio of 1.43–8.95, a rate ratio of 1.6–2.88, an odds ratio of 1.34, with a prevalence of ovarian cancer in 2.0–17.0% of women with endometriosis. Conversely, the prevalence of endometriosis in women with ovarian cancer ranged from 3.4 to 52.6%. Meta-analysis results were weakened by heterogeneity.
There is sufficient evidence to conclude that there is an increased risk of developing clear-cell and endometrioid epithelial ovarian cancer for women with histologically verified endometriosis. Nonetheless, prospective cohort studies assessing the relation between endometriosis and ovarian cancer will increase knowledge in this field.