Association of benign gynaecological diseases and risk of endometrial and ovarian cancers

Abstract

Objective: Gynaecologic benign diseases such uterine fibroids share similar pathogeneses with endometrial and ovarian cancers. Whether a history of uterine fibroids increases the risk of developing endometrial or ovarian cancers is controversial, due to uterine fibroids was self-reported in those studies. Methods: In our current case-control study, 268 women with endometrial cancer and 108 women with ovarian cancer were included. In addition, 500 women without gynaecological cancers were randomly selected as a control group. Uterine fibroids in both groups were clinically diagnosed by pelvic examination and ultrasound. Data on age, parity, gravida, stages of cancers and history of uterine fibroids, endometriosis and adenomyosis were collected from hospital database. Results: After adjusted age and parity, the odds of women with history of uterine fibroids or endometriosis were lower in women with endometrial cancer than controls (odds ratio: 0.148, 95% CI: 0.097, 0.225, or 0.360, 95% CI: 0094, 1.381, respectively). The odds of women with a history of uterine fibroids or endometriosis were lower in women with ovarian cancer than controls (odds ratio: 0.141, 95% CI: 0.085, 0.235, or 1.057, 95% CI: 0.377, 2.963, respectively). However, the odds of women with a history of adenomyosis were higher in women with endometrial or ovarian cancers than controls (odd ratio: 3.757, 95% CI: 1.858, 7.599 or 2.341, 95% CI: 1.086, 5.045, respectively). Conclusion: Our observational data suggested that uterine fibroids or endometriosis may be not associated with the increased risk of developing endometrial or ovarian cancer. However, a history of adenomyosis may do.

There is no significant correlation of adenomyosis with benign, premalignant and malignant gynecological pathologies. Retrospective study on 647 specimens

“…In our series, we confirmed that endometrial cancer appears in 3.6% of adenomyosis patients, followed by ovarian cancer (1.4%) and cervical cancer (0.8%) (Table 3). Well of note, the National Cancer Institute mentions that approximately 3.1 % of women will be diagnosed with uterine cancer, less than 2% with ovarian cancer and 0, 6% with cervical cancer at some point during their lifetime [31]. Thus, according to our data, we did not observe a significant risk of developing gynecological malignancy in women with adenomyosis compared to cases with no previous pathology of adenomyosis.…”

Endometrial Cancer Incidence in Endometriosis and Adenomyosis

“…Several studies have shown that endometriosis is associated with an increased risk of ovarian cancer, specifically endometrioid and clear cell ovarian subtypes [ 9 , 10 , 11 ]. However, contradictory evidence exists as to whether endometriosis and adenomyosis are associated with endometrial cancer [ 11 , 12 , 13 , 14 , 15 ]. Additionally, most studies included women with clinical or surgical endometriosis/adenomyosis, whereas histological diagnosis is still considered the gold standard [ 2 ].…”

“…Additionally, most studies included women with clinical or surgical endometriosis/adenomyosis, whereas histological diagnosis is still considered the gold standard [ 2 ]. Furthermore, studies on adenomyosis and endometrial cancer included small samples sizes [ 13 , 14 , 15 ].…”

History of Endometriosis Is Independently Associated with an Increased Risk of Ovarian Cancer

“…It is probable that the different results obtained in our study could be attributed to the sample size, as our study include a greater number of patients. In this line, Tseng et al [ 31 ] also identified, in a broader sample size, that patients with uterine fibroids had a 2.26-fold higher risk of developing ovarian cancer than patients without uterine fibroids, and this risk could significantly decrease after myomectomy or hysterectomy. However, further studies are required before drawing relevant conclusions.…”

“…Gestational diabetes mellitus (GDM) constitutes one of the most representative and worrisome complications among pregnant women [ 31 ]. GDM is not only associated with adverse pregnancy outcomes but also has significant long-term implications on health conditions [ 32 ].…”