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      The association between endometriosis and risk of endometrial cancer and breast cancer: a meta-analysis

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          Abstract

          Purpose

          Endometriosis (EMS) is confirmed pathophysiologically to be an estrogen-dependent disease, similar to endometrial hyperplasia/cancer and breast cancer. Epidemiological and biological data on endometriosis might explain links between endometriosis and these cancers. We sought to identify the differences in the risk of endometrial cancer and breast cancer between women with and women without endometriosis.

          Methods

          We searched PubMed, EMBASE, the Cochrane Library, and four Chinese databases (CNKI, VIP, WanFang, CBM) to identify relevant studies published online between January 2011 and March 2021. In our meta-analysis, we used the Newcastle–Ottawa Scale (NOS) to evaluate the design and quality of all studies, and we calculated the pooled risk ratio (RR) using the random model. The Q test and I 2 were used to evaluate the degree of heterogeneity of eligible studies. We used funnel plots and Begg’s and Egger’s tests to assess publication bias.

          Results

          Of the 1369 articles, we finally included 14 cohort studies and seven case–control studies. Data from large cohort and case–control studies indicate that women with endometriosis had an increased risk of both endometrial cancer [RR, 1.662; 95% CI, (1.148–2.407)] and breast cancer [RR, 1.082; 95% CI, (1.001–1.169)].

          Conclusion

          Endometriosis can increase the risk of endometrial cancer and breast cancer, and women with endometriosis are recommended to receive routine screening in long-term management.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12905-022-02028-x.

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          Most cited references51

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          Measuring inconsistency in meta-analyses.

          Julian P. T. Higgins, Simon Thompson, Jonathan Deeks … (2003)
          Article 0 comments Cited 10159 times – based on 0 reviews     Review now
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            Endometriosis

            Krina Zondervan, Robert N Taylor, Stacey Missmer … (2018)
            Endometriosis is a common inflammatory disease characterized by the presence of tissue outside the uterus that resembles endometrium, mainly on pelvic organs and tissues. It affects ~5-10% of women in their reproductive years - translating to 176 million women worldwide - and is associated with pelvic pain and infertility. Diagnosis is reliably established only through surgical visualization with histological verification, although ovarian endometrioma and deep nodular forms of disease can be detected through ultrasonography and MRI. Retrograde menstruation is regarded as an important origin of the endometrial deposits, but other factors are involved, including a favourable endocrine and metabolic environment, epithelial-mesenchymal transition and altered immunity and inflammatory responses in genetically susceptible women. Current treatments are dictated by the primary indication (infertility or pelvic pain) and are limited to surgery and hormonal treatments and analgesics with many adverse effects that rarely provide long-term relief. Endometriosis substantially affects the quality of life of women and their families and imposes costs on society similar to those of other chronic conditions such as type 2 diabetes mellitus, Crohn's disease and rheumatoid arthritis. Future research must focus on understanding the pathogenesis, identifying disease subtypes, developing non-invasive diagnostic methods and targeting non-hormonal treatments that are acceptable to women who wish to conceive.
            Article 0 comments Cited 309 times – based on 0 reviews     Review now
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              ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up.

              N Colombo, C. Creutzberg, F Amant … (2016)
              The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11-13 December 2014 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically relevant questions about endometrial cancer relating to the following four areas: prevention and screening, surgery, adjuvant treatment and advanced and recurrent disease. All relevant scientific literature, as identified by the experts, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. Results of this consensus conference, together with a summary of evidence supporting each recommendation, are detailed in this article. All participants have approved this final article.
              Article 0 comments Cited 282 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Xiaorong Qi:
                ORCID: http://orcid.org/0000-0002-8382-9433
                qixiaorong11@163.com
                Journal
                Journal ID (nlm-ta): BMC Womens Health
                Journal ID (iso-abbrev): BMC Womens Health
                Title: BMC Women's Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1472-6874
                Publication date (Electronic): 18 November 2022
                Publication date PMC-release: 18 November 2022
                Publication date Collection: 2022
                Volume: 22
                Electronic Location Identifier: 455
                Affiliations
                [1 ]GRID grid.13291.38, ISNI 0000 0001 0807 1581, Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, , Sichuan University, ; Chengdu, People’s Republic of China
                [2 ]GRID grid.410604.7, Department of Gynecology and Obstetrics, , The Fourth People’s Hospital, ; Zigong, People’s Republic of China
                Author information
                https://orcid.org/0000-0002-0419-3984
                http://orcid.org/0000-0002-8382-9433
                Article
                Publisher ID: 2028
                DOI: 10.1186/s12905-022-02028-x
                PMC ID: 9673303
                PubMed ID: 36401252
                SO-VID: 856c4425-0f60-45b8-808d-0cf728ee2af6
                Copyright © © The Author(s) 2022
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 20 February 2022
                Date accepted : 25 October 2022
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2022

                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: endometriosis,endometrial cancer,breast cancer,risk,meta-analysis
                Data availability:
                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: endometriosis, endometrial cancer, breast cancer, risk, meta-analysis

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