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Association between endometriosis and gynecological cancers: a critical review of the literature

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Abstract

Background

Endometriosis is one of the most common benign gynecological diseases with an occurrence approximately 10% in reproductive age. Endometriosis has been proposed as a possible precursor of certain ovarian carcinomas such as clear cell and endometrioid ovarian carcinomas. In addition to this pathogenic link, the association with other gynecological tumors and breast cancer has been studied on an epidemiological basis in several studies.

Objective

The aim of this review was to critically present the recent published evidence on the association of endometriosis with gynecological cancer, and with a special emphasis on ovarian cancer.

Materials and methods

A search for eligible studies was conducted in three electronic databases, MEDLINE, EMBASE and CINAHL, for original research in humans published in any language.

Results

The present review includes studies examining the association between endometriosis and different types of gynecological cancer (i.e., 25 studies on ovarian cancer, 8 studies on breast cancer, 8 studies on endometrial cancer and 2 studies on cervical cancer).

Conclusion

The present literature supports the pre-existing evidence suggesting an association between ovarian cancer and endometriosis and specifically its two histologic subtypes (endometrioid and ovarian clear cell cancer). The most recent population-based epidemiological studies cannot provide a clear association between endometriosis and endometrial, cervical or breast cancer.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Cantonal Hospital Schaffhausen, Geissbergstrasse 81, 8208, Schaffhausen, Switzerland

    Dimitrios Rafail Kalaitzopoulos

  2. Society of Junior Doctors, Surgery Workgroup, Athens, Greece

    Dimitrios Rafail Kalaitzopoulos, Angeliki Mitsopoulou, Sotiria Maria Iliopoulou & Konstantinos P. Economopoulos

  3. Department of Gynecology, St.-Johannes-Hospital Dortmund, Dortmund, Germany

    Angeliki Mitsopoulou

  4. Department of Psychiatry, University Hospital of Geneve, Geneve, Switzerland

    Sotiria Maria Iliopoulou

  5. 2nd University Department of Obstetrics and Gynecology, Hippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Angelos Daniilidis

  6. Department of Gynecology, University Hospital Zurich, Zurich, Switzerland

    Eleftherios P. Samartzis

  7. Department of Surgery, Duke University School of Medicine, Durham, USA

    Konstantinos P. Economopoulos

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DRK, SMI, and KPE: project development, data collection, and manuscript writing. AM: data collection. EPS and AD: manuscript writing

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Kalaitzopoulos, D.R., Mitsopoulou, A., Iliopoulou, S.M. et al. Association between endometriosis and gynecological cancers: a critical review of the literature. Arch Gynecol Obstet 301, 355–367 (2020). https://doi.org/10.1007/s00404-020-05445-1

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