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Surgical treatment of endometriosis lowers the risk of ovarian cancer

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Surgical treatment of endometriosis lowers the risk of Ovarian Cancer

A new study by led researchers at the Karolinska Institute shows that women who are treated surgically for endometriosis have a lower risk of developing ovarian cancer. However it seems that drug therapy (ie hormonal) for endometriosis did not reduce the risk of ovarian cancer.
Endometriosis is a leading cause of infertility in young women (aged between 25 and 40 years). Endometriosis is characterized by endometrial tissue outside the uterus, which most often is found in the fallopian tubes, ovaries, or other organs in the pelvis. Symptoms and signs of this disease are due to hormonal changes during the menstrual cycle: abdominal pain, menorrhagia, pelvic pain or back pain, dysmenorrhea etc. This endometrial tissue lining acts as the lining inside the uterus ( which means that every month it bleeds), and over time cysts and areas of fibrous tissue develop in those locations where endometrial tissue is found.



Endometriosis treatment is aimed at reducing estrogen levels and consists of medication and surgery. Drug treatment includes several types of drugs such as oral contraceptives, aromatase inhibitors, agonists and antagonists of Gn-RH and the main goal is to adjust the level of estrogen hormones to reduce symptoms of endometriosis. Surgery may be conservative, ie ectopic endometrial tissue removal, or radical, which involves removing the ovaries and/or uterus.

Statistics show that endometriosis affects approximately 14% of fertile women. Some studies have shown that women with endometriosis are at increased risk for certain cancers such as cancer of the ovary. Other studies, in contrast, showed that women with endometriosis who are treated surgically (tubal ligation or hysterectomy) have a lower risk of developing these cancers. Dr. Anna-Sofia Melin from the Karolinska Institute and Karolinska University Hospital in Stockholm, Sweden, the lead-author, explained that patients with endometriosis are typically treated with hormone therapy or in severe cases through surgery. She added that they wanted to see which is the association between the two types of treatment (surgical and hormonal) and ovarian cancer risk.

The study included patients diagnosed with endometriosis that were selected from the Swedish National Patient Register during 1969-2007. There have been found 220 women with ovarian cancer and endometriosis and 416 women with endometriosis only. Dr. Melin said that the study showed a significant correlation between ovarian cancer risk and removal of ovarian or endometrial tissue visible. “Our study suggests that surgical removal of an ovary and removal of visible endometriosis protects women from developing ovarian cancer at a later point,” concludes Dr. Melin.