Wen-Hsun Chang1, Kuan-Chin Wang2, Wen-Ling Lee3, Nicole Huang4, Yiing-Jeng Chou4, Rung-Chuang Feng5, Ming-Shyen Yen6, Ben-Shian Huang7, Chao-Yu Guo8, Peng-Hui Wang9. 1. Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, National Yang-Ming University, Taipei, Taiwan; Institute of Hospital and Health Care Administration and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. 2. Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan. 3. Department of Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan; Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan. 4. Institute of Hospital and Health Care Administration and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. 5. Department of Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Nursing, Taipei City Hospital, Taipei, Taiwan. 6. Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan. 7. Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University Hospital, Ilan, Taiwan. 8. Institute of Hospital and Health Care Administration and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. Electronic address: cyguo@ym.edu.tw. 9. Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University Hospital, Ilan, Taiwan; Immunology Center, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. Electronic address: phwang@vghtpe.gov.tw.
Abstract
OBJECTIVE: There is a possible correlation between endometriosis and an increased risk of epithelial ovarian cancer (EOC), but many uncertainties remain, including race, exposure or surveillance time, and surgical confirmation. Therefore, we carried out a large-scale, nationwide, controlled cohort study in the Taiwanese women to respond to these uncertainties. MATERIALS AND METHODS: A historical cohort study was performed by linking the National Health Insurance Research Database of Taiwan. Each patient diagnosed with endometriosis (n = 7537) between 2000 and 2009 was background matched with up to two women without endometriosis (n = 15,074). The total was 136,643 person-years of follow-up and 24 women having new EOC. Cox regression analysis was used to determine the relationship between the EOC incidence rate and an endometriosis status. RESULTS: The EOC incidence rate of the endometriosis and non-endometriosis women was 3.31 per 10,000 person-years and 0.99 per 10,000 person-years, respectively, contributing to an adjusted hazard ratio (HR) of 3.28 (95% confidence interval, 1.37-7.85). The women with surgical confirmation had a much higher adjusted HR (3.87; 95% confidence interval, 1.58-9.47). No significantly statistical difference of surveillance time between women with and without endometriosis (3.87 years vs. 3.73 years). The occurrence of EOC was not also affected by exposure time of women with endometriosis. CONCLUSION: Taiwanese women with endometriosis really had a risk of newly developed EOC, especially those who had a surgical diagnosis, and this three-fold increase of risk was neither influenced by exposure time nor biased by surveillance.
OBJECTIVE: There is a possible correlation between endometriosis and an increased risk of epithelial ovarian cancer (EOC), but many uncertainties remain, including race, exposure or surveillance time, and surgical confirmation. Therefore, we carried out a large-scale, nationwide, controlled cohort study in the Taiwanese women to respond to these uncertainties. MATERIALS AND METHODS: A historical cohort study was performed by linking the National Health Insurance Research Database of Taiwan. Each patient diagnosed with endometriosis (n = 7537) between 2000 and 2009 was background matched with up to two women without endometriosis (n = 15,074). The total was 136,643 person-years of follow-up and 24 women having new EOC. Cox regression analysis was used to determine the relationship between the EOC incidence rate and an endometriosis status. RESULTS: The EOC incidence rate of the endometriosis and non-endometriosiswomen was 3.31 per 10,000 person-years and 0.99 per 10,000 person-years, respectively, contributing to an adjusted hazard ratio (HR) of 3.28 (95% confidence interval, 1.37-7.85). The women with surgical confirmation had a much higher adjusted HR (3.87; 95% confidence interval, 1.58-9.47). No significantly statistical difference of surveillance time between women with and without endometriosis (3.87 years vs. 3.73 years). The occurrence of EOC was not also affected by exposure time of women with endometriosis. CONCLUSION: Taiwanese women with endometriosis really had a risk of newly developed EOC, especially those who had a surgical diagnosis, and this three-fold increase of risk was neither influenced by exposure time nor biased by surveillance.
Authors: Hsing-Chi Hsu; Kai-Yu Tseng; Hsiang-Chi Wang; Fung-Chan Sung; Wei-Fen Ma Journal: Int J Environ Res Public Health Date: 2019-09-18 Impact factor: 3.390