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The Link Between Endometriosis and Ovarian Cancer: Clinical Implications
  1. Farr Reza Nezhat, MD*,
  2. Tanja Pejovic, MD, PhD,
  3. Fernando M. Reis, MD, PhD and
  4. Sun-Wei Guo, MD, PhD§
  1. *Divisions of Gynecologic Oncology and Minimally Invasive Gynecologic Surgery & Robotics, Department of Obstetrics and Gynecology, St Luke’s and Roosevelt Hospitals, Member hospitals ofthe Mount Sinai Health System and the Icahn School of Medicine, New York, NY;
  2. Division of Gynecologic Oncology, Oregon Health and Science University, Portland, OR;
  3. Division of Human Reproduction, Department of Obstetrics and Gynecology, University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; and
  4. §Shanghai Obstetrics and Gynecology Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  1. Address correspondence and reprint requests to Farr Reza Nezhat, MD, Mount Sinai Roosevelt, Department of Obstetrics and Gynecology-Administration, 1000 10th Avenue, Ste 10-C, New York, NY 10019. E-mail: FNezhat{at}


Objectives The objectives of this study were to evaluate the current evidence of the association of endometriosis and subsequent carcinoma of the ovary and to contextualize this evidence into daily practice issues.

Methods This study is a critical review of observational and in vitro studies.

Results Although the lifetime risk for ovarian cancer is low in general population and remains low in the broad spectrum of endometriosis, there may be clusters of individuals at higher risk of oncogenesis, whose identification would allow individualized surveillance and prophylactic interventions. Prevalence studies show that specific subtypes of ovarian cancer predominate in women with endometriosis. This has been validated in pathogenetic, genomic, immunobiologic, and hormonal studies.

Conclusions Taken together, these data provide a strong rationale for identifying, monitoring, counseling, and treating women with endometriosis who are at highest risk for cancer conversion.

  • Clinical implications
  • Endometriosis
  • Ovarian carcinoma subtype

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  • The authors declare no conflicts of interest.