Researchers found that women with severe endometriosis have nearly a 10-fold increased risk of developing ovarian cancer as compared to those without the condition

Study Finds Dramatic Increase in Ovarian Cancer Risk for Those with Severe Endometriosis

Researchers found that women with severe endometriosis have nearly a 10-fold increased risk of developing ovarian cancer as compared to those without the condition

• Women with severe endometriosis have almost a 10-times higher risk of developing ovarian cancer, a recent study found.
• The research also saw an increased risk of ovarian cancer for those with endometriosis in general around four times higher.
• Experts hope the research will bring attention to testing for both endometriosis and ovarian cancer.

Endometriosis can bring severe pelvic and period pain, and now research suggests a significant increase in ovarian cancer risk, too.

For years, scientists have warned of a connection between the two conditions. However, a study published in JAMA this past summer found that the risk of developing ovarian cancer is nearly 10 times higher in women with severe endometriosis as compared to those without the condition. For those with endometriosis in general, the risk of ovarian cancer is 4.2 times higher.

“The magnitude of the risk associated with endometriosis is much higher than previously estimated,” Sarah Adams, MD, a professor of obstetrics and gynecology at the University of New Mexico Cancer Center, told Health.

Approximately 11% of Americans between the ages of 15 and 44 assigned female at birth have endometriosis. With this condition, cells that are similar to tissue in the uterus grow outside of the uterus, causing pain, bleeding, and other issues.

There are a few different types of endometriosis—deep infiltrating endometriosis is the rarest and most severe, but it appears to raise a woman’s risk of ovarian cancer most significantly, explained Tamer Seckin, MD, an endometriosis surgeon at Lenox Hill Hospital and co-founder of the Endometriosis Foundation of America.

“We know ovarian cancer affects a small amount [of people], but it is deadly,” Seckin told Health.

About 1.1% of women in the U.S. develop ovarian cancer.

The Link Between Endometriosis and Ovarian Cancer

Previous research has shown a connection between these two conditions, including a 2021 meta-analysis that found that endometriosis could put women at a slightly higher risk of ovarian cancer. However, the authors emphasized that a majority of the studies they reviewed had bias.

To further investigate the connection, the new JAMA study looked at nearly 451,000 women in the Utah Population database, all of whom were between the ages of 18 and 55. About 78,500 women had endometriosis, and about 372,400 did not. Researchers also used the Utah Cancer Registry to determine that 597 of these women developed ovarian cancer between 1992 and 2019.

From there, they further broke down the data to reveal associations between different types of ovarian cancer and different types of endometriosis.

“This study is different from prior studies because they further categorized patients based on their type of endometriosis and type of ovarian cancer,” Christine Metz, PhD, professor and endometriosis researcher at the Northwell Health Feinstein Institutes for Medical Research, told Health.

Overall, the data showed women with endometriosis had a higher ovarian cancer risk.

For type I ovarian cancer—which usually grows locally, more slowly, and has better outcomes—the risk was 7.48-fold higher in those with endometriosis.

People with deep infiltrating endometriosis and/or ovarian endometriomas—more severe forms of the condition—had an 18.96-fold increased risk of type I ovarian cancer. They had a 3.72-fold higher risk of type II ovarian cancer, which is more aggressive.

“That’s where we found a 19-fold increased risk, which compares to the connection between smoking and lung cancer,” Karen Schliep, PhD, an author and associate professor from the University of Utah in Salt Lake City, Utah, said in a press release. “As an epidemiologist, seeing numbers like that is really striking.”

There are a few limitations to the study, Metz pointed out. For one, there was data missing on whether the participants used oral contraceptives or gonadotropin-releasing hormone (GnRH) agonists, which are sometimes used to treat endometriosis. Though more evidence is needed on how GnRH agonists affect cancer risk, evidence suggests contraceptive use could lower risk.

However, experts agree that endometriosis is likely involved in the development of ovarian cancer in some way.

The authors of this study suggested that ovarian cancer could be derived from endometriosis lesions, Metz said.

Another theory is that genetic factors connected to the development of endometriosis somehow overlap with ovarian cancer, she explained.

“The genes are there,” said Seckin. “They’re ready to be provoked.”

Endometriosis doesn’t necessarily cause cancer, Seckin clarified. However, “endometriosis probably opens the door wide to cancer-causing situations.”

What to Do If You Have Endometriosis

Though the study found a significantly higher risk of ovarian cancer for people with severe endometriosis, Schliep told Health that “our results should in no way alarm women” because “ovarian cancer is rare.”

However, even if it is a bit scary, it’s important that people with endometriosis are aware of this connection, Mary Lou Ballweg, author and president and executive director of the Endometriosis Association, told Health.

Currently, there’s a lack of reliable screening tests for ovarian cancer, and people usually aren’t screened for ovarian cancer unless they have a genetic condition or family history, placing them at very high risk. But doctors can utilize pelvic exams, blood tests, and transvaginal ultrasounds if necessary to check for signs of the cancer.

According to the JAMA study, the findings indicate that people with endometriosis “may benefit from counseling regarding ovarian cancer risk and prevention.”

To that end, this kind of research could be helpful in alerting clinicians to this connection and encouraging better diagnosis and treatment of endometriosis, Seckin said.

“People diminish how important it is,” he said. “I think this [study] is really going to trigger some attention.”

In general, symptoms of endometriosis—which include painful periods and cramping—are often dismissed, and many women are underdiagnosed because of it, Ballweg explained.

“People aren’t paying attention because they don’t think it affects young women,” she said.

Endometriosis isn’t necessarily preventable, but there is some evidence that exercising regularly, avoiding large amounts of alcohol and caffeine, and using hormonal birth control could lower a person’s risk.

Julia is a news reporter and editor for Health, where she covers breaking and trending news on health and wellness topics. Her work has been featured in The Heights, an independent student newspaper at Boston College, and Minnesota Monthly.

This story originally appeared on: Health News - Author:Kristen Fischer