Department of Obstetrics and Gynaecology, Aberdeen Royal Infirmary, Aberdeen, UK.
Medical Statistics Team, University of Aberdeen, Aberdeen, UK.
BJOG. 2018 Jan;125(1):64-72. doi: 10.1111/1471-0528.14793. Epub 2017 Sep 27.
To evaluate the long-term risk of further gynaecological surgery and cancer in women with endometriosis.
Cohort study.
Scotland.
281 937 women with nearly 5 million person years (4 923 628) of follow up from 1981 to 2010.
In this national population-based study we compared 17 834 women with a new surgical diagnosis of endometriosis with 83 303 women with no evidence of endometriosis at laparoscopy, 162 966 women who underwent laparoscopic sterilisation, and 17 834 age-matched women from the general population. Cox proportional hazards regression was used to calculate crude and adjusted hazard ratios with 95% confidence intervals.
Risk of further gynaecological surgery, number and type of repeat surgery and time to repeat surgery from the diagnosis of endometriosis. Cancer outcomes included subsequent risk of all cancer, gynaecological and non-gynaecological cancers.
Women with endometriosis had a significantly higher risk of further surgery when compared with women with no evidence of endometriosis at laparoscopy [hazard ratio (HR) 1.69, 95% (confidence interval) CI 1.65-1.73], women who had undergone laparoscopic sterilisation (HR 3.30, 95% CI 3.23-3.37) and age-matched women from the general population (HR 5.95, 95% CI 5.71-6.20). They also have an increased risk of ovarian cancer when compared with general population counterparts (HR 1.77, 95% CI 1.08-2.89) or those with laparoscopic sterilisation (HR 1.75, 95% CI 1.2-2.45).
Women with surgically diagnosed endometriosis face an increased risk of multiple surgery. They have a higher chance of developing ovarian cancer in comparison with the general population and women with laparoscopic sterilisation.
Women with endometriosis face an increased risk of recurrent surgery and developing ovarian cancer.
评估子宫内膜异位症女性进一步妇科手术和癌症的长期风险。
队列研究。
苏格兰。
281937 名女性，随访时间近 500 万人年（4923628 人），随访时间从 1981 年至 2010 年。
在这项全国性基于人群的研究中，我们比较了 17834 名新诊断为子宫内膜异位症的女性与腹腔镜检查无子宫内膜异位症证据的 83303 名女性、162966 名接受腹腔镜绝育术的女性和 17834 名年龄匹配的一般人群中的女性。使用 Cox 比例风险回归计算了粗风险比和调整风险比及其 95%置信区间。
从子宫内膜异位症诊断开始，进一步手术的风险、重复手术的数量和类型以及重复手术的时间。癌症结局包括所有癌症、妇科癌症和非妇科癌症的后续风险。
与腹腔镜检查无子宫内膜异位症证据的女性（危险比 [HR]1.69，95%置信区间 [CI]1.65-1.73）、接受腹腔镜绝育术的女性（HR3.30，95%CI3.23-3.37）和年龄匹配的一般人群中的女性（HR5.95，95%CI5.71-6.20）相比，子宫内膜异位症女性进一步手术的风险显著更高。与一般人群相比（HR1.77，95%CI1.08-2.89）或与接受腹腔镜绝育术的女性相比（HR1.75，95%CI1.2-2.45），她们发生卵巢癌的风险也增加。
诊断为子宫内膜异位症的女性面临多次手术的风险增加。与一般人群和接受腹腔镜绝育术的女性相比，她们发生卵巢癌的几率更高。
患有子宫内膜异位症的女性面临着更高的再次手术风险和患卵巢癌的风险。
