Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland.
Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Acta Obstet Gynecol Scand. 2023 Oct;102(10):1329-1337. doi: 10.1111/aogs.14556. Epub 2023 Mar 25.
The incidence and prevalence of pelvic endometriosis is still being debated. Population-based studies have shown annual incidences between 0.1% and 0.3%, which translates to a prevalence of symptom-giving disease of between 2% and 6% over a 20-year span in the reproductive years. However, a prevalence of 10% or higher is often assumed. We used Iceland's extensive record linkage possibilities, secure access to patient data and personal identification numbers to search for all cases with a surgical and/or histological first diagnosis over a 15-year study period.
Information was obtained from all healthcare facilities where an operative and/or histological diagnosis of pelvic endometriosis might have been made during 2001-2015. Hospital discharge diagnostic data and private clinic data sources were scrutinized and double-checked through a central register. Individual medical records, operation notes and pathology records were inspected. Visually and pathologically diagnosed cases were included. The data covered women aged 15-69 years, but the age range 15-49 (reproductive years) was specifically considered. Annual incidence was estimated per 10 000 person-years and prevalence possibilities calculated for varying disease durations. Disease severity was staged (revised American Society for Reproductive Medicine classification) and main lesion sites determined.
A total of 1634 women 15-69 years old were diagnosed; 1487 of them between 15 and 49 years old. Histological verification was obtained for 57.1%. The age-standardized annual incidence for all confirmed endometriosis diagnoses was 12.5/10 000 person-years among women in their reproductive years. The overall estimate of prevalence was 0.6%-3.6%, dependent on duration of symptoms from 5 up to 30 years. The most common sites by order of frequency were ovaries, deep pelvis, central pelvis, vesicouterine pouch and uterine appendages. Of the women, 1080 (66.1%) had minimal/mild and 553 (33.8%) moderate/severe disease.
We have in a comprehensive study covering a recent 15-year period confirmed an annual incidence of pelvic endometriosis of between 0.1% and 0.15% in the female population of reproductive age. Endometriosis is variably severe but, depending on the duration of symptomatic disease, the approximated prevalence during women's reproductive years could range from 1% to 4%.
盆腔子宫内膜异位症的发病率和患病率仍存在争议。基于人群的研究显示，年发病率在 0.1%至 0.3%之间，这意味着在生育期的 20 年内，有症状疾病的患病率在 2%至 6%之间。然而，通常假设患病率为 10%或更高。我们利用冰岛广泛的记录链接可能性、对患者数据和个人识别号码的安全访问，在 15 年的研究期间搜索了所有有手术和/或组织学初次诊断的病例。
信息来自于 2001 年至 2015 年间可能进行盆腔子宫内膜异位症手术和/或组织学诊断的所有医疗机构。仔细审查了医院出院诊断数据和私人诊所数据源，并通过中央登记处进行了双重检查。检查了个人病历、手术记录和病理记录。包括肉眼和病理诊断的病例。该数据涵盖了 15-69 岁的女性，但特别考虑了 15-49 岁（生育期）的年龄范围。估计了每 10000 人年的年发病率，并计算了不同疾病持续时间的患病率。对疾病严重程度进行分期（修订后的美国生殖医学协会分类），并确定主要病变部位。
共有 1634 名 15-69 岁的女性被诊断为子宫内膜异位症；其中 1487 名年龄在 15 至 49 岁之间。57.1%的病例获得了组织学验证。在生育期妇女中，所有确诊的子宫内膜异位症诊断的年龄标准化年发病率为 12.5/10000 人年。根据症状持续时间从 5 年到 30 年的不同，总体患病率估计为 0.6%-3.6%。按频率顺序最常见的部位依次为卵巢、深部盆腔、中央盆腔、膀胱子宫陷凹和子宫附件。在这些女性中，1080 名（66.1%）为轻度/轻度，553 名（33.8%）为中度/重度。
在一项涵盖最近 15 年的综合研究中，我们证实了生育期女性的盆腔子宫内膜异位症年发病率在 0.1%至 0.15%之间。子宫内膜异位症的严重程度各不相同，但根据症状性疾病的持续时间，在女性生育期，估计患病率可能在 1%至 4%之间。
