ImportanceEndometriosis has been associated with an increased risk of ovarian cancer; however, the associations between endometriosis subtypes and ovarian cancer histotypes have not been well-described.ObjectiveTo evaluate the associations of endometriosis subtypes with incidence of ovarian cancer, both overall and by histotype.Design, Setting, and ParticipantsPopulation-based cohort study using data from the Utah Population Database. The cohort was assembled by matching 78 893 women with endometriosis in a 1:5 ratio to women without endometriosis.ExposuresEndometriosis cases were identified via electronic health records and categorized as superficial endometriosis, ovarian endometriomas, deep infiltrating endometriosis, or other.Main Outcomes and MeasuresEstimated adjusted hazard ratios (aHRs), adjusted risk differences (aRDs) per 10 000 women, and 95% CIs for overall ovarian cancer, type I ovarian cancer, and type II ovarian cancer comparing women with each type of endometriosis with women without endometriosis. Models accounted for sociodemographic factors, reproductive history, and past gynecologic operations.ResultsIn this Utah-based cohort, the mean (SD) age at first endometriosis diagnosis was 36 (10) years. There were 597 women with ovarian cancer. Ovarian cancer risk was higher among women with endometriosis compared with women without endometriosis (aHR, 4.20 [95% CI, 3.59-4.91]; aRD, 9.90 [95% CI, 7.22-12.57]), and risk of type I ovarian cancer was especially high (aHR, 7.48 [95% CI, 5.80-9.65]; aRD, 7.53 [95% CI, 5.46-9.61]). Ovarian cancer risk was highest in women with deep infiltrating endometriosis and/or ovarian endometriomas for all ovarian cancers (aHR, 9.66 [95% CI, 7.77-12.00]; aRD, 26.71 [95% CI, 20.01-33.41]), type I ovarian cancer (aHR, 18.96 [95% CI, 13.78-26.08]; aRD, 19.57 [95% CI, 13.80-25.35]), and type II ovarian cancer (aHR, 3.72 [95% CI, 2.31-5.98]; aRD, 2.42 [95% CI, −0.01 to 4.85]).Conclusions and RelevanceOvarian cancer risk was markedly increased among women with ovarian endometriomas and/or deep infiltrating endometriosis. This population may benefit from counseling regarding ovarian cancer risk and prevention and could be an important population for targeted screening and prevention studies.

中文翻译：

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子宫内膜异位症类型和卵巢癌风险


重要性子宫内膜异位症与卵巢癌风险增加有关；然而，子宫内膜异位症亚型与卵巢癌组织型之间的关联尚未得到很好的描述。目的评估子宫内膜异位症亚型与卵巢癌发病率的总体和组织型之间的关联。设计、设置和参与者基于人群的队列研究，使用来自以下数据的数据：犹他州人口数据库。该队列是通过将 78 893 名患有子宫内膜异位症的女性与没有子宫内膜异位症的女性按照 1:5 的比例进行匹配而组建的。暴露子宫内膜异位症病例通过电子健康记录进行识别，并分类为浅表子宫内膜异位症、卵巢子宫内膜异位症、深层浸润性子宫内膜异位症或其他。主要结果和措施估计将患有每种类型子宫内膜异位症的女性与未患有子宫内膜异位症的女性进行比较，对总体卵巢癌、I 型卵巢癌和 II 型卵巢癌的调整后风险比 (aHR)、每 10 000 名女性调整后风险差异 (aRD) 和 95% CI 进行比较。模型考虑了社会人口统计学因素、生育史和既往妇科手术。结果在这个犹他州队列中，首次诊断子宫内膜异位症的平均 (SD) 年龄为 36 (10) 岁。有 597 名女性患有卵巢癌。与无子宫内膜异位症的女性相比，患有子宫内膜异位症的女性患卵巢癌的风险更高（aHR，4.20 [95% CI，3.59-4.91]；aRD，9.90 [95% CI，7.22-12.57]），并且 I 型卵巢癌的风险为特别高（aHR，7.48 [95% CI，5.80-9.65]；aRD，7.53 [95% CI，5.46-9.61]）。对于所有卵巢癌，患有深部浸润性子宫内膜异位症和/或卵巢子宫内膜异位瘤的女性，卵巢癌风险最高（aHR，9.66 [95% CI，7.77-12.00]；aRD，26.71 [95% CI，20.01-33.41]），I 型卵巢癌（aHR，18.96 [95% CI，13.78-26.08]； aRD，19.57 [95% CI，13.80-25.35]）和 II 型卵巢癌（aHR，3.72 [95% CI，2.31-5.98]；aRD，2.42 [95% CI，-0.01 至 4.85]）。结论和相关性 患有卵巢子宫内膜异位症和/或深部浸润性子宫内膜异位症的女性患卵巢癌的风险显着增加。该人群可能受益于有关卵巢癌风险和预防的咨询，并且可能成为有针对性的筛查和预防研究的重要人群。