The risks for endometrial hyperplasia and endometrial cancer were significantly higher in women with than without endometriosis.

The risks were higher in women aged <45 years and in those with BMI <23 kg/m2.

Why this matters

Findings suggest that periodic surveillance of the endometrium in women with endometriosis is needed, as it can result in earlier diagnosis and treatment of endometrial hyperplasia and endometrial cancer.

Study design

A population-based observational study of 147,869 women who were diagnosed with endometriosis from 2002 to 2017 and 2,957,380 matched individuals without endometriosis.

Key results

About 16,377 women were diagnosed with endometrial hyperplasia, and 1795 women were diagnosed with endometrial cancer over 19,931,794 person-years of follow-up.

Women with endometriosis compared with those without it were at significantly higher risk for:

  • Endometrial hyperplasia (aHR, 1.85; 95% CI, 1.75-1.95).
  • Endometrial cancer (aHR, 1.35; 95% CI, 1.12-1.63).

The risks for endometrial hyperplasia and endometrial cancer were greater in:

  • Women diagnosed with endometriosis before 45 years of age (aHR, 2.16; 95% CI, 2.02-2.30 and aHR, 1.56; 95% CI, 1.18-2.06).
  • Women with BMI <23 kg/m2 (aHR, 2.14; 95% CI, 1.99-2.30 and aHR, 1.38; 95% CI, 1.03-1.85).
  • Women who had experienced menarche at age < 15 years (aHR, 1.99; 95% CI, 1.84-2.15 and aHR, 1.43; 95% CI, 1.06-1.91).

A diagnosis of endometriosis did not affect survival in patients with endometrial cancer.


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