Factors contributing to the delayed diagnosis of endometriosis-a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review of non-randomized observational studies
PubMed 40766070 · doi:10.3389/fmed.2025.1576490
What was done
A systematic review and random-effects meta-analysis was conducted across PubMed, Cochrane, and Google Scholar to determine causes of delayed endometriosis diagnosis. From 2,348 records retrieved, 10 articles met inclusion criteria. Contributing factors were categorized as patient-, physician-, and systems-related. Heterogeneity was assessed via the I² statistic, and publication bias was evaluated with funnel plots and Egger's test.
What was found
Patient-related factors contributed significantly to diagnostic delay (pooled SMD: 1.94, 95% CI: 1.62–2.27, p < 0.001), with delays in seeking care having the largest effect (SMD: 2.14, 95% CI: 1.36–2.92). Provider-related factors, such as misdiagnosis and non-specific diagnostic reliance, also showed a large pooled effect (SMD: 2.00, 95% CI: 1.72–2.28, p < 0.001) with low heterogeneity (I² = 3%). System-related factors were not meta-analyzed due to insufficient data. Egger's test showed no significant publication bias (p = 0.57).
Why it matters
The findings demonstrate that prolonged endometriosis diagnostic delays are driven substantially by both patient-level hesitancy/symptom normalization and clinical provider misrecognition.
Limits
Only 10 studies were included, and total participant counts are not stated in the abstract. Systemic and structural healthcare factors could not be quantitatively evaluated. The underlying studies are observational with potential confounding and varying definitions of delay.
Cited by
- supports The average age of diagnosis for endometriosis is 32 years old.