Women with endometriosis are at higher risk of having recurrent reproductive system surgeries and developing ovarian cancer than women without the disease, a study shows.
They are also at higher risk of those consequences than women who have had laparoscopic sterilization.
The study, “Impact of endometriosis on risk of further gynaecological surgery and cancer: a national cohort study,” was published in BJOG: An International Journal of Public Health.
Thirty to 50 percent of women with endometriosis complain of pain five years after having surgery or other treatments for their condition.
Because surgery is the main treatment for endometriosis, women often have more than one operation to alleviate pain. Hysterectomy is the most common surgical option when other treatments fail and fertility is not a concern.
Most studies on pain that recurs after treatment have dealt with short- or medium-term outcomes. No researchers have conducted long-term studies with large groups to evaluate the risk of endometriosis patients having additional surgeries.
Another concern for endometriosis patients is developing certain cancers, particularly ovarian cancer. Most studies that have assessed the link between the two have relied on self-reported diagnoses of endometriosis and focused on subgroups, such as infertile patients. The bottom line is that research on this issue has many limitations.
This prompted researchers at the University of Aberdeen and Edinburgh to see whether endometriosis can affect the risk of recurrent reproductive-system surgeries and the development of cancer.
The team looked at the records of 17,834 women newly diagnosed with endometriosis, 83,303 with no evidence of endometriosis, 162,966 who had had laparoscopic sterilization, and 17,834 age-matched controls. They looked at the risk of further gynecological surgery, the number and types of surgery, the time it took before another surgery occurred, and the women’s risk of all cancers.
Women with endometriosis were at 69 percent higher risk of having additional surgery than women without endometriosis. In addition, the risk of women with endometriosis having additional surgery was more than triple that of women who had had laparoscopic sterilization, and 5 1/2 times higher than for the controls.
Researchers also demonstrated that women with endometriosis were at 77 percent higher risk of developing ovarian cancer than age-matched controls, and at 75 percent higher risk than women who had had laparoscopic sterilization.
“Endometriosis is a common gynecological condition, but little is known about the long-term surgical risks in women,” Dr. Lucky Saraswat, the consulting gynecologist at the University of Aberdeen who led the study, said in a press release.
“Our study shows that women with the condition have a higher risk of repeat surgery,” she said. “Greater awareness of the risk of multiple surgical procedures, including hysterectomy, can be useful in counseling women with a new diagnosis of endometriosis and enable them to make timely reproductive choices.”
Professor John Thorpe, the deputy editor of BJOG, noted that “this is the largest study of the long-term risks women with endometriosis face and should help both healthcare professionals and patients when making decisions about treatment.”