SYSTEMATIC REVIEW article
Front. Med.
Sec. Obstetrics and Gynecology
This article is part of the Research TopicMolecular Insights into the Tumor Progression of Endocrine and Hormone-sensitive CancersView all articles
Clarifying the Link Between Endometriosis and Cancer: A Meta-analysis of Studies with Confirmed Temporality and Diagnostic Precision
Provisionally accepted
- Ganzhou People's Hospital, Ganzhou, China
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Introduction: Prior meta-analyses linking endometriosis to cancer have been limited by unclear temporality and reliance on self-reported diagnoses. This systematic review and meta-analysis to assess the risk of subsequent cancer in women with surgically or pathologically confirmed endometriosis. Methods: We searched PubMed, Scopus, Web of Science, and Google Scholar from October 24, 2019, to January 14, 2025. Eligible studies included observational designs comparing cancer incidence between women with and without endometriosis, with confirmed diagnosis and ensured temporality. Only hazard ratios (HRs) adjusted for at least two confounders were pooled. Risk of bias was assessed and random-effects meta-analyses were performed. Results: Eleven studies (n = 7,686,424) met inclusion criteria. Women with endometriosis had a higher risk of any cancer (2 studies, adjusted HR (aHR) 1.29, 95% CI: 1.17–1.41) and ovarian cancer (4 studies, aHR 2.55, 95% CI: 0.92–4.19). Unadjusted pooled analyses showed significantly increased risks for ovarian cancer (7 studies, OR 3.56, 95% CI: 2.39–5.31), breast cancer (5 studies, OR 1.55, 95% CI: 1.30–1.85), thyroid cancer (2 studies, OR 1.41, 95% CI: 1.10–1.81), and melanoma (1 study, OR 1.82, 95% CI: 1.27–2.61). Strongest associations were observed for endometrioid and clear-cell ovarian cancer subtypes. Heterogeneity was low for subtype-specific analyses and moderate to high elsewhere. Overall, five studies were rated as methodologically excellent and six as high quality. Conclusion: Endometriosis is associated with increased risk of several malignancies, particularly ovarian and hormone-sensitive cancers. This analysis supports the need for long-term vigilance in affected women.
Keywords: Cancer, Endometriosis, Meta-analysis, surgically-confirmed, Systematic review
Received: 06 Dec 2025; Accepted: 15 Jan 2026.
Copyright: © 2026 Song, Liqin and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yunjing Song
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