title: Incidence of endometriosis by study population and diagnostic method: the ENDO study.
abstract: OBJECTIVE
  To estimate the incidence of endometriosis in an operative cohort of women seeking clinical care and in a matched population cohort to delineate more fully the scope and magnitude of endometriosis in the context of and beyond clinical care.
  
  
  METHODS
  Matched-exposure cohort design.
  
  
  METHODS
  Surgical centers in the Salt Lake City, Utah, and San Francisco, California, areas.
  
  
  METHODS
  The operative cohort comprised 495 women undergoing laparoscopy/laparotomy between 2007 and 2009, and the population cohort comprised 131 women from the surgical centers' catchment areas.
  
  
  METHODS
  None.
  
  
  METHODS
  Incidence of endometriosis by diagnostic method in the operative cohort and by pelvic magnetic resonance imaged (MRI) disease in the population cohort.
  
  
  RESULTS
  Endometriosis incidence in the operative cohort ranged by two orders of magnitude by diagnostic method: 0.7% for only histology, 7% for only MRI, and 41% for visualized disease. Endometriosis staging was skewed toward minimal (58%) and mild disease (15%). The incidence of MRI-diagnosed endometriosis was 11% in the population cohort.
  
  
  CONCLUSIONS
  Endometriosis incidence is dependent on the diagnostic method and choice of sampling framework. Conservatively, 11% of women have undiagnosed endometriosis at the population level, with implications for the design and interpretation of etiologic research.
authors: Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland 20852, USA. louisg@mail.nih.gov
authors: Germaine M
authors: GM
authors: Buck Louis
authors: Mary L
authors: ML
authors: Hediger
authors: C Matthew
authors: CM
authors: Peterson
authors: Mary
authors: M
authors: Croughan
authors: Rajeshwari
authors: R
authors: Sundaram
authors: Joseph
authors: J
authors: Stanford
authors: Zhen
authors: Z
authors: Chen
authors: Victor Y
authors: VY
authors: Fujimoto
authors: Michael W
authors: MW
authors: Varner
authors: Ann
authors: A
authors: Trumble
authors: Linda C
authors: LC
authors: Giudice
mesh_terms: D000328:Adult; D001706:Biopsy; D015331:Cohort Studies; D004715:Endometriosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D015340:Epidemiologic Research Design; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology