Vol 17, No 3 (2021)
Review paper
Published online: 2021-04-20

open access

Page views 627
Article views/downloads 490
Get Citation

Connect on Social Media

Connect on Social Media

Endometriosis and risk of ovarian cancer

Yavor Kornovski1, Yonka Atanasova1, Stoyan Kostov2, Stanislav Slavchev1, Angel Danchev Yordanov3
Oncol Clin Pract 2021;17(3):125-127.


Endometriosis is common in premenopausal women and affects about 10% of women of reproductive age. It is a benign condition but demonstrates malignant behaviour with recurrences and metastases. Its tendency to increase the risk of specific subtypes of ovarian cancer is being discussed, because they exhibit specific clinical features that distinguish them from classical ovarian cancer. Malignant transformation of endometriosis goes through its transition to atypical endometriosis. Although endometriosis-associated ovarian carcinomas have a good prognosis, adequate follow-up and monitoring after treatment of endometriosis are recommended.

Article available in PDF format

View PDF Download PDF file


  1. Králíčková M, Laganà AS, Ghezzi F, et al. Endometriosis and risk of ovarian cancer: what do we know? Arch Gynecol Obstet. 2020; 301(1): 1–10.
  2. Nassif J, Mattar S, Abu Musa A, et al. Endometriosis and cancer: what do we know? Minerva Ginecol. 2013; 65(2): 167–179.
  3. Guerriero S, Condous G, van den Bosch T, et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol. 2016; 48(3): 318–332.
  4. Sofo V, Götte M, Laganà AS, et al. Correlation between dioxin and endometriosis: an epigenetic route to unravel the pathogenesis of the disease. Arch Gynecol Obstet. 2015; 292(5): 973–986.
  5. Vetvicka V, Kralickova M. Current theories on endometriosis pathogenesis. Edorium J Mol Pathol. 2015; 1: 1–4.
  6. Hunn J, Rodriguez GC. Ovarian cancer: etiology, risk factors, and epidemiology. Clin Obstet Gynecol. 2012; 55(1): 3–23.
  7. Sayasneh A, Tsivos D, Crawford R. Endometriosis and ovarian cancer: a systematic review. ISRN Obstet Gynecol. 2011; 2011: 140310.
  8. Vlahos NF, Kalampokas T, Fotiou S. Endometriosis and ovarian cancer: a review. Gynecol Endocrinol. 2010; 26(3): 213–219.
  9. Szubert M, Suzin J, Obirek K, et al. Clear cell ovarian cancer and endometriosis: is there a relationship? Prz Menopauzalny. 2016; 15(2): 85–89.
  10. LaGrenade A, Silverberg SG. Ovarian tumors associated with atypical endometriosis. Hum Pathol. 1988; 19(9): 1080–1084.
  11. Maiorana A, Cicerone C, Niceta M, et al. Evaluation of serum CA 125 levels in patients with pelvic pain related to endometriosis. Int J Biol Markers. 2007; 22(3): 200–202.
  12. Zhou Y, Hua KQ. Ovarian endometriosis: risk factor analysis and prediction of malignant transformation. Prz Menopauzalny. 2018; 17(1): 43–48.
  13. Pearce CL, Templeman C, Rossing MA, et al. Ovarian Cancer Association Consortium. Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case-control studies. Lancet Oncol. 2012; 13(4): 385–394.
  14. Wei JJ, William J, Bulun S. Endometriosis and ovarian cancer: a review of clinical, pathologic, and molecular aspects. Int J Gynecol Pathol. 2011; 30(6): 553–568.
  15. Aris A. Endometriosis-associated ovarian cancer: A ten-year cohort study of women living in the Estrie Region of Quebec, Canada. J Ovarian Res. 2010; 3: 2.
  16. Heidemann LN, Hartwell D, Heidemann CH, et al. The relation between endometriosis and ovarian cancer - a review. Acta Obstet Gynecol Scand. 2014; 93(1): 20–31.
  17. Kobayashi H, Sumimoto K, Kitanaka T, et al. Ovarian endometrioma--risks factors of ovarian cancer development. Eur J Obstet Gynecol Reprod Biol. 2008; 138(2): 187–193.
  18. Orezzoli JP, Russell AH, Oliva E, et al. Prognostic implication of endometriosis in clear cell carcinoma of the ovary. Gynecol Oncol. 2008; 110(3): 336–344.
  19. Worley MJ, Welch WR, Berkowitz RS, et al. Endometriosis-associated ovarian cancer: a review of pathogenesis. Int J Mol Sci. 2013; 14(3): 5367–5379.
  20. Grandi G, Toss A, Cortesi L, et al. The Association between Endometriomas and Ovarian Cancer: Preventive Effect of Inhibiting Ovulation and Menstruation during Reproductive Life. Biomed Res Int. 2015; 2015: 751571.
  21. Zorn KK, Tian C, McGuire WP, et al. The prognostic value of pretreatment CA 125 in patients with advanced ovarian carcinoma: a Gynecologic Oncology Group study. Cancer. 2009; 115(5): 1028–1035.
  22. Kim HS, Kim TH, Chung HH, et al. Risk and prognosis of ovarian cancer in women with endometriosis: a meta-analysis. Br J Cancer. 2014; 110(7): 1878–1890.
  23. Siufi Neto J, Kho RM, Siufi DF, et al. Cellular, histologic, and molecular changes associated with endometriosis and ovarian cancer. J Minim Invasive Gynecol. 2014; 21(1): 55–63.
  24. Modugno F, Ness RB, Allen GO, et al. Oral contraceptive use, reproductive history, and risk of epithelial ovarian cancer in women with and without endometriosis. Am J Obstet Gynecol. 2004; 191(3): 733–740.
  25. Melin AS, Lundholm C, Malki N, et al. Hormonal and surgical treatments for endometriosis and risk of epithelial ovarian cancer. Acta Obstet Gynecol Scand. 2013; 92(5): 546–554.
  26. Merritt MA, De Pari M, Vitonis AF, et al. Reproductive characteristics in relation to ovarian cancer risk by histologic pathways. Hum Reprod. 2013; 28(5): 1406–1417.
  27. Saavalainen L, Lassus H, But A, et al. Risk of Gynecologic Cancer According to the Type of Endometriosis. Obstet Gynecol. 2018; 131(6): 1095–1102.