Impact of endometriosis on risk of further gynaecological surgery and cancer

a national cohort study

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9 Citations (Scopus)
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Abstract

Objective

To evaluate the long-term risk of further gynaecological surgery and cancer in women with endometriosis.
Design

Cohort study.
Setting

Scotland.
Participants

281 937 women with nearly 5 million person years (4 923 628) of follow up from 1981 to 2010.
Methods

In this national population-based study we compared 17 834 women with a new surgical diagnosis of endometriosis with 83 303 women with no evidence of endometriosis at laparoscopy, 162 966 women who underwent laparoscopic sterilisation, and 17 834 age-matched women from the general population. Cox proportional hazards regression was used to calculate crude and adjusted hazard ratios with 95% confidence intervals.
Main outcome measures

Risk of further gynaecological surgery, number and type of repeat surgery and time to repeat surgery from the diagnosis of endometriosis. Cancer outcomes included subsequent risk of all cancer, gynaecological and non–gynaecological cancers.
Results

Women with endometriosis had a significantly higher risk of further surgery when compared with women with no evidence of endometriosis at laparoscopy [hazard ratio (HR) 1.69, 95% (confidence interval) CI 1.65–1.73], women who had undergone laparoscopic sterilisation (HR 3.30, 95% CI 3.23–3.37) and age-matched women from the general population (HR 5.95, 95% CI 5.71–6.20). They also have an increased risk of ovarian cancer when compared with general population counterparts (HR 1.77, 95% CI 1.08–2.89) or those with laparoscopic sterilisation (HR 1.75, 95% CI 1.2–2.45).
Conclusion

Women with surgically diagnosed endometriosis face an increased risk of multiple surgery. They have a higher chance of developing ovarian cancer in comparison with the general population and women with laparoscopic sterilisation.
Original languageEnglish
Pages (from-to)64-72
Number of pages9
JournalBJOG-An International Journal of Obstetrics and Gynaecology
Volume125
Issue number1
Early online date27 Sep 2017
DOIs
Publication statusPublished - Jan 2018

Fingerprint

Gynecologic Surgical Procedures
Endometriosis
Cohort Studies
Neoplasms
Population
Reoperation
Ovarian Neoplasms
Laparoscopy
Confidence Intervals

Keywords

  • cancer
  • endometriosis
  • recurrent surgery
  • hysterectomy

Cite this

@article{a43d1041c3e346daadef10a74f551b89,
title = "Impact of endometriosis on risk of further gynaecological surgery and cancer: a national cohort study",
abstract = "ObjectiveTo evaluate the long-term risk of further gynaecological surgery and cancer in women with endometriosis.DesignCohort study.SettingScotland.Participants281 937 women with nearly 5 million person years (4 923 628) of follow up from 1981 to 2010.MethodsIn this national population-based study we compared 17 834 women with a new surgical diagnosis of endometriosis with 83 303 women with no evidence of endometriosis at laparoscopy, 162 966 women who underwent laparoscopic sterilisation, and 17 834 age-matched women from the general population. Cox proportional hazards regression was used to calculate crude and adjusted hazard ratios with 95{\%} confidence intervals.Main outcome measuresRisk of further gynaecological surgery, number and type of repeat surgery and time to repeat surgery from the diagnosis of endometriosis. Cancer outcomes included subsequent risk of all cancer, gynaecological and non–gynaecological cancers.ResultsWomen with endometriosis had a significantly higher risk of further surgery when compared with women with no evidence of endometriosis at laparoscopy [hazard ratio (HR) 1.69, 95{\%} (confidence interval) CI 1.65–1.73], women who had undergone laparoscopic sterilisation (HR 3.30, 95{\%} CI 3.23–3.37) and age-matched women from the general population (HR 5.95, 95{\%} CI 5.71–6.20). They also have an increased risk of ovarian cancer when compared with general population counterparts (HR 1.77, 95{\%} CI 1.08–2.89) or those with laparoscopic sterilisation (HR 1.75, 95{\%} CI 1.2–2.45).ConclusionWomen with surgically diagnosed endometriosis face an increased risk of multiple surgery. They have a higher chance of developing ovarian cancer in comparison with the general population and women with laparoscopic sterilisation.",
keywords = "cancer, endometriosis, recurrent surgery, hysterectomy",
author = "Lucky Saraswat and Ayansina, {Dolapo Toyese} and KG Cooper and Siladitya Bhattacharya and Horne, {A. W.} and Sohinee Bhattacharya",
note = "Funded by Chief Scientist Office, Scotland",
year = "2018",
month = "1",
doi = "10.1111/1471-0528.14793",
language = "English",
volume = "125",
pages = "64--72",
journal = "BJOG-An International Journal of Obstetrics and Gynaecology",
issn = "1470-0328",
publisher = "John Wiley & Sons, Ltd (10.1111)",
number = "1",

}

TY - JOUR

T1 - Impact of endometriosis on risk of further gynaecological surgery and cancer

T2 - a national cohort study

AU - Saraswat, Lucky

AU - Ayansina, Dolapo Toyese

AU - Cooper, KG

AU - Bhattacharya, Siladitya

AU - Horne, A. W.

AU - Bhattacharya, Sohinee

N1 - Funded by Chief Scientist Office, Scotland

PY - 2018/1

Y1 - 2018/1

N2 - ObjectiveTo evaluate the long-term risk of further gynaecological surgery and cancer in women with endometriosis.DesignCohort study.SettingScotland.Participants281 937 women with nearly 5 million person years (4 923 628) of follow up from 1981 to 2010.MethodsIn this national population-based study we compared 17 834 women with a new surgical diagnosis of endometriosis with 83 303 women with no evidence of endometriosis at laparoscopy, 162 966 women who underwent laparoscopic sterilisation, and 17 834 age-matched women from the general population. Cox proportional hazards regression was used to calculate crude and adjusted hazard ratios with 95% confidence intervals.Main outcome measuresRisk of further gynaecological surgery, number and type of repeat surgery and time to repeat surgery from the diagnosis of endometriosis. Cancer outcomes included subsequent risk of all cancer, gynaecological and non–gynaecological cancers.ResultsWomen with endometriosis had a significantly higher risk of further surgery when compared with women with no evidence of endometriosis at laparoscopy [hazard ratio (HR) 1.69, 95% (confidence interval) CI 1.65–1.73], women who had undergone laparoscopic sterilisation (HR 3.30, 95% CI 3.23–3.37) and age-matched women from the general population (HR 5.95, 95% CI 5.71–6.20). They also have an increased risk of ovarian cancer when compared with general population counterparts (HR 1.77, 95% CI 1.08–2.89) or those with laparoscopic sterilisation (HR 1.75, 95% CI 1.2–2.45).ConclusionWomen with surgically diagnosed endometriosis face an increased risk of multiple surgery. They have a higher chance of developing ovarian cancer in comparison with the general population and women with laparoscopic sterilisation.

AB - ObjectiveTo evaluate the long-term risk of further gynaecological surgery and cancer in women with endometriosis.DesignCohort study.SettingScotland.Participants281 937 women with nearly 5 million person years (4 923 628) of follow up from 1981 to 2010.MethodsIn this national population-based study we compared 17 834 women with a new surgical diagnosis of endometriosis with 83 303 women with no evidence of endometriosis at laparoscopy, 162 966 women who underwent laparoscopic sterilisation, and 17 834 age-matched women from the general population. Cox proportional hazards regression was used to calculate crude and adjusted hazard ratios with 95% confidence intervals.Main outcome measuresRisk of further gynaecological surgery, number and type of repeat surgery and time to repeat surgery from the diagnosis of endometriosis. Cancer outcomes included subsequent risk of all cancer, gynaecological and non–gynaecological cancers.ResultsWomen with endometriosis had a significantly higher risk of further surgery when compared with women with no evidence of endometriosis at laparoscopy [hazard ratio (HR) 1.69, 95% (confidence interval) CI 1.65–1.73], women who had undergone laparoscopic sterilisation (HR 3.30, 95% CI 3.23–3.37) and age-matched women from the general population (HR 5.95, 95% CI 5.71–6.20). They also have an increased risk of ovarian cancer when compared with general population counterparts (HR 1.77, 95% CI 1.08–2.89) or those with laparoscopic sterilisation (HR 1.75, 95% CI 1.2–2.45).ConclusionWomen with surgically diagnosed endometriosis face an increased risk of multiple surgery. They have a higher chance of developing ovarian cancer in comparison with the general population and women with laparoscopic sterilisation.

KW - cancer

KW - endometriosis

KW - recurrent surgery

KW - hysterectomy

U2 - 10.1111/1471-0528.14793

DO - 10.1111/1471-0528.14793

M3 - Article

VL - 125

SP - 64

EP - 72

JO - BJOG-An International Journal of Obstetrics and Gynaecology

JF - BJOG-An International Journal of Obstetrics and Gynaecology

SN - 1470-0328

IS - 1

ER -