Endometriosis and ovarian cancer risk.
Level 3 - non-randomized controlled study
Systematic review of observational cohort studies combined with expert narrative review
PubMed 42119308 · doi:10.1016/j.ygyno.2026.05.004
What was done
The authors performed a systematic review following PRISMA guidelines combined with a multidisciplinary narrative review informed by expert panel discussion to evaluate the association between endometriosis and ovarian cancer risk, with a specific focus on endometrioid and clear cell subtypes, to guide risk stratification and clinical counseling.
What was found
Cohort studies reported relative risks of ovarian cancer ranging from 1.3 to 4.2 in women with endometriosis compared to those without, with the highest estimates observed in women with ovarian endometriomas or deep infiltrating disease, particularly for endometrioid and clear cell subtypes. Molecular alterations including mutations in ARID1A, PIK3CA, and PTEN, along with epigenetic and inflammatory/estrogen-dependent pathway dysregulation, were identified as shared features. The absolute lifetime risk of ovarian cancer in women with endometriosis was reported as generally <2-5%.
Why it matters
This review distinguishes relative risk from absolute risk to guide clinical practice, emphasizing that the low absolute risk does not justify routine oncologic screening or prophylactic surgery for patients with endometriosis.
Limits
The abstract does not report the number of included studies, total participant count, search date ranges, or whether quantitative meta-analysis was performed. The epidemiological conclusions rely on observational cohort studies that are vulnerable to confounding, and the synthesis includes non-systematic narrative expert review.
Cited by
- supports Endometriosis carries a slightly increased risk of ovarian cancer, particularly in patients with endometriomas or advanced disease.