Global Burden of Endometriosis in 204 Countries and Territories from 1990 to 2019

Abstract

Background: To our knowledge, no systematic update on the descriptive epidemiology of endometriosis and its trends has been published based on the Global Burden of Disease (GBD) datasets. To investigate the burden of endometriosis in 204 countries and territories from 1990 to 2019. Methods: Data were extracted from the Global Burden of Disease (GBD) 2019 datasets. Estimated annual percentage changes (EAPCs) were calculated to assess trends in the incidence and disability-adjusted life-years (DALYs) of endometriosis. Measures were stratified by region, country, age, and socio-demographic index (SDI). Results: From 1990 to 2019, the global incidence and DALYs of endometriosis increased by 10.37% and 16.36%, respectively. However, both the age-standardized incidence rate (ASIR) and agestandardized DALY rate of endometriosis showed downward trends (EAPC = -0.81 and -0.80, respectively). The ASIR decreased in all SDI regions, with the largest decrease observed in low-middle SDI regions [EAPC = -1.19, 95% Confidence Interval (CI): -1.21 to -1.16] except Eastern Europe, the only region where the ASIR increased (EAPC = 0.15, 95% CI: 0.01 to 0.29). The largest decreases in the ASIR and age-standardized DALY rate of endometriosis were observed in Qatar and Oman, respectively. Conclusions: The global incidence and DALYs of endometriosis continued to increase during 1990-2019. However, the ASIR and age-standardized DALY rate have shown decreasing trends worldwide, with increasing trends detected only in Eastern Europe.

Global risks of endometriosis in women – an appraisal

“…4,8,9,[11][12][13] Endometriosis affected 3,430,094 individuals worldwide in 1990, and 3,785,955 people in 2019, an increase of approximately 10 percent. 38 Endometriosis affects 5-15 percent of women in reproductive age and 2-5 percent of postmenopausal women in Canada and the United States, respectively. 25 It is estimated that more than 4 million women of reproductive age have been diagnosed with endometriosis, according to population-based investigations.…”

“…5,20 It should be noted, however, that these conclusions are based on limited evidence and could be influenced by factors such as healthcare access, diagnostic equipment, and cultural perceptions of women's health issues. 13,38 Ethnicity, along with socio-economic, cultural, and genetic factors, may affect a person's ability to access healthcare and receive proper endometriosis treatment. 5,11…”

“…8,23,24,26 This could be because they have improved healthcare facilities and can thus be diagnosed faster. 8,23,26,38 Endometriosis prevalence and incidence data are scarce or non-existent in many low-income countries and locations. 38 There was an insignificant association found between eating chicken, fish, shellfish, or eggs and the risk of endometriosis, but the consumption of red meat may increase the risk of endometriosis.…”

Editorial: The impact of endometriosis

“…However, there is still a long diagnostic delay of approximately 8–12 years ( 2 ). Additionally, the disability-adjusted life-years (DALYs) of endometriosis has increased between 1990 and 2019 ( 8 ). The scientific community have been working to standardize the research on endometriosis ( 9 – 12 ]) and increase collaborations with public engagement charities and organizations to improve awareness.…”

DataSheet_1.docx

“…Endometriosis (EM) is a chronic disease characterized by the presence of functional endometrium outside the uterine cavity (1). It is a very frequent gynecological disorder that affects around 10-15% of reproductive-aged women, with an overall prevalence of about 18% (2,3). EM is commonly associated with pelvic pain, dyschezia, dyspareunia, dysmenorrhea, and infertility (4).…”