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Surgical treatment of endometriosis lowers the risk of ovarian cancer

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Compared with hormonal treatment or no intervention, surgical intervention was associated with a reduced risk of ovarian cancer


 

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Women who undergo surgical treatment of endometriosis can lower their risk of ovarian cancer, according to data from Sweden.1 Hormonal treatment of endometriosis does not lower the risk of ovarian cancer.

Earlier research revealed an increased risk of several cancers, including ovarian cancer, in women with endometriosis. Some found a protective effect against ovarian cancer with surgical intervention, such as hysterectomy or tubal ligation.

“Patients with endometriosis typically are treated with hormones or, in more severe cases, with surgery,” said lead author Dr. Anna-Sofia Melin from the Karolinska Institute and Karolinska University Hospital in Stockholm, Sweden. “We wanted to expand understanding of ovarian cancer risk in women with endometriosis who had some type of surgery or hormone therapy.”

Using the National Swedish Patient Register, the team identified women given a diagnosis of endometriosis between 1969 and 2007. They then used the National Swedish Cancer Register to link women who were given a diagnosis of epithelial ovarian cancer at least 1 year after a diagnosis of endometriosis. Information on hormonal and surgical treatments was taken from the medical records of 220 women who had both endometriosis and ovarian cancer and 416 who had only endometriosis.

Among women who underwent oophorectomy, the risk of ovarian cancer declined significantly (crude odds ratio [OR], 0.42; 95% confidence interval [CI], 0.28–0.62). Women who underwent radical surgical extirpation of all visible endometriosis also had a lower risk of ovarian cancer (OR, 0.37; 95% CI, 0.25–0.55).

“Our study suggests that surgical removal of an ovary and removal of visible endometriosis protects women from developing ovarian cancer at a later point,” said Dr. Melin. “For women with endometriosis, the role of hormonal treatment and future ovarian cancer risk remains unclear.”

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