The association between endometriosis and risk of endometrial cancer and breast cancer: a meta-analysis

Abstract

Purpose Endometriosis (EMS) is confirmed pathophysiologically to be an estrogen-dependent disease, similar to endometrial hyperplasia/cancer and breast cancer. Epidemiological and biological data on endometriosis might explain links between endometriosis and these cancers. We sought to identify the differences in the risk of endometrial cancer and breast cancer between women with and women without endometriosis. Methods We searched PubMed, EMBASE, the Cochrane Library, and four Chinese databases (CNKI, VIP, WanFang, CBM) to identify relevant studies published online between January 2011 and March 2021. In our meta-analysis, we used the Newcastle–Ottawa Scale (NOS) to evaluate the design and quality of all studies, and we calculated the pooled risk ratio (RR) using the random model. The Q test and I2 were used to evaluate the degree of heterogeneity of eligible studies. We used funnel plots and Begg’s and Egger’s tests to assess publication bias. Results Of the 1369 articles, we finally included 14 cohort studies and seven case–control studies. Data from large cohort and case–control studies indicate that women with endometriosis had an increased risk of both endometrial cancer [RR, 1.662; 95% CI, (1.148–2.407)] and breast cancer [RR, 1.082; 95% CI, (1.001–1.169)]. Conclusion Endometriosis can increase the risk of endometrial cancer and breast cancer, and women with endometriosis are recommended to receive routine screening in long-term management.

Global increased cesarean section rates and public health implications: A call to action

“…Globally, the prevalence of endometriosis among reproductive age women and girls is 10%, 46 despite the fact that the specific contribution of CS to this magnitude is unknown. Moreover, several studies have found significant association of endometriosis and an increased likelihood of developing various cancers including ovarian cancer, endometrial, and breast cancer 47,48 . Other than direct health implications, CS are associated with increased health expenditures 49,50 .…”

“…Moreover, several studies have found significant association of endometriosis and an increased likelihood of developing various cancers including ovarian cancer, endometrial, and breast cancer. 47,48 Other than direct health implications, CS are associated with increased health expenditures. 49,50 With the growing burden of health system financing, increased CS rate is likely to exert extra pressure to the health system that may be detrimental in LMICs.…”

Endometriosis: Update of Pathophysiology, (Epi) Genetic and Environmental Involvement

“…Interestingly, endometriosis was associated with a minimally increased risk of breast cancer (less than 10%). Only rare studies reported an increased risk for estrogen receptor-positive (ERþ)/progesterone receptor-negative (PR) breast cancer (ERþ/PR: HR = 1.90, 95% CI = 1.44–2.50) [ 50 , 51 ].…”

“…The association with endometrial cancer is controversial [ 50 , 51 ] probably because some biases complicate analyses. For instance, patients with lean size (low BMI) have an increased risk of endometriosis [ 15 ].…”

Chasing Uterine Cancer with NK Cell-Based Immunotherapies

“…KIR expression is also heterogenous due to allelic variation in KIR genes [70]. Of note, KIRs can exhibit both an inhibitory and activating type, and a decrease in the KIR2DS2 (an activating KIR that recognizes HLA-C1 allotypes and HLA-A*11:01) is associated with an increased risk of endometriosis, which is well-correlated with EC risk (Table 1) [73][74][75][76][77]. Integrins, such as α5(CD49e) and β1(CD29) (fibronectin receptor), are receptors of extracellular matrix proteins that typically exhibit low levels of expression on NK cells in adults but increase in some tumors [33,78] (Table 1).…”