Uterine cancer risk in "endometriosis" and "adenomyosis"Oct 25, 2021
Endometrial cancer risk in women with endometriosis/adenomyosis needs to be clarified.
- This study shows an increased incidence of endometrial cancer in women with histologically proven endometriosis and adenomyosis, especially for extensive endometriosis/adenomyosis disease burden.
- Endometrial cancer risk in women with endometriosis/adenomyosis needs to be clarified and risk stratification for cancer development should be developed.
- Endometrial sampling before hysterectomy should be required step false for cases of endometriosis or adenomyosis, as endometrial cancer can be incidentally diagnosed.
What's done here:
- A research team from the Netherlands aimed to assess the uterine cancer risk in women histopathologically diagnosed with "endometriosis" and "adenomyosis".
- A retrospective cohort study comprising approximately 130.000 endometriosis/adenomyosis diagnosed women matched with a similar number of dermal nevus patients.
- Histopathologically diagnosed endometrial cancer were retrieved from the registry and the probability for endometrial cancer was estimated.
- Endometrial cancer detection was frequent at the time of histological diagnosis of endometriosis/adenomyosis.
- In one-fifth of the endometrial cancer cases, endometrial cancer was not recognized until hysterectomy was performed.
- Among the endometrial cancer patients, one-third did not have a prior endometrial biopsy.
- The highest risk is for endometrioid type endometrial cancer.
Strengths and Limitations:
Adenomyosis and endometriosis share similar characteristics, and endometriosis is reported to have an increased risk of ovarian cancer. However, the risk of uterine cancer is not clear yet.
Hermens and colleagues from Catharina Hospital, from the Netherlands, designed a population-based retrospective cohort study from the Dutch pathology registry. The patients with the histological diagnosis of adenomyosis, endometriosis, and dermal nevus from this large patient pool between the years 1990-2015 were selected, and adenomyosis/endometriosis, solely endometriosis or adenomyosis; and dermal nevus they cohorts were compared.
When uterine cancer cases were evaluated, a synchronous histopathologic diagnosis of endometriosis/adenomyosis and endometrial cancer was surprising on the hysterectomy specimens. The cancer was not recognized until a hysterectomy was performed. One-third of endometrial cancer patients did not have a prior endometrial biopsy, and the highest risk was for endometrioid type endometrial cancer.
The endometrial cancer risk was low in patients who responded well to hormonal therapy with endometriosis/adenomyosis, after more than a year of follow-up. The authors thought that the reason could be "adequate exposure" to hormone therapy which may decrease the risk of endometrial cancer.
This paper was recently published in "Cancers (Basel)".
Research Source: https://pubmed.ncbi.nlm.nih.gov/34572823/
adenomyosis risk endometrial cancer ovarian cancer endometriosis.