Endometriosis is one of the few known disease precursors to ovarian cancer. This information is not meant to alarm patients but to inform them about the importance of close monitoring and making informed choices for their future health.
Initially, studies indicated a 3-4 fold increase in ovarian cancer risk for patients with pathology-proven endometriosis. To put this in perspective, the lifetime risk of ovarian cancer in the general population is 1 in 87. For endometriosis patients, it was previously estimated at 1 in 50.
Endometriosis affects 1 in 8-10 individuals born with a uterus (approximately 11% of the population). Comparatively, breast cancer affects 1 in 8 women.
More recent studies estimate a significantly higher ovarian cancer risk in patients with deeply infiltrating endometriosis (DIE), with an 18-19 fold increase. This new data may lead to recommendations for risk-reducing surgeries, such as salpingectomy, similar to those for BRCA2 mutation carriers.
Even without the recent findings, we recommend yearly follow-up with your gynecologist and pelvic imaging every 1-2 years, although this is not ACOG-endorsed. This guidance comes from Dr. G’s extensive experience managing endometriosis patients and observing disease progression.
Early salpingectomy (removal of fallopian tubes) combined with endometriosis excision can be an effective risk-reduction strategy.
References:
Barnard ME, Farland LV, Yan B, et al. Endometriosis Typology and Ovarian Cancer Risk. JAMA. Published online July 17, 2024. doi:10.1001/jama.2024.9210
Kahn RM, Stone RL, Long Roche KC. Salpingectomy and Ovarian Cancer Prevention—Reply. JAMA Surg. 2024;159(4):470. doi:10.1001/jamasurg.2023.7773
