title: Endometriosis: a high-risk population for major chronic diseases?
abstract: BACKGROUND
  Despite an estimated prevalence of 10% in women, the etiology of endometriosis remains poorly understood. Over recent decades, endometriosis has been associated with risk of several chronic diseases, such as cancer, autoimmune diseases, asthma/atopic diseases and cardiovascular diseases. A deeper understanding of these associations is needed as they may provide new leads into the causes or consequences of endometriosis. This review summarizes the available epidemiological findings on the associations between endometriosis and other chronic diseases and discusses hypotheses for underlying mechanisms, potential sources of bias and methodological complexities.
  
  
  METHODS
  We performed a comprehensive search of the PubMed/Medline and ISI Web of Knowledge databases for all studies reporting on the associations between endometriosis and other diseases published in English through to May 2014, using numerous search terms. We additionally examined the reference lists of all identified papers to capture any additional articles that were not identified through computer searches.
  
  
  RESULTS
  We identified 21 studies on the associations between endometriosis and ovarian cancer, 14 for breast cancer, 8 for endometrial cancer, 4 for cervical cancer, 12 for cutaneous melanoma and 3 for non-Hodgkin's lymphoma, as well as 9 on the links between endometriosis and autoimmune diseases, 6 on the links with asthma and atopic diseases, and 4 on the links with cardiovascular diseases. Endometriosis patients were reported to be at higher risk of ovarian and breast cancers, cutaneous melanoma, asthma, and some autoimmune, cardiovascular and atopic diseases, and at decreased risk of cervical cancer.
  
  
  CONCLUSIONS
  Increasing evidence suggests that endometriosis patients are at higher risk of several chronic diseases. Although the underlying mechanisms are not yet understood, the available data to date suggest that endometriosis is not harmless with respects to women's long-term health. If these relationships are confirmed, these findings may have important implications in screening practices and in the management and care of endometriosis patients.
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115, USA Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), 'Nutrition, Hormones and Women's Health' Team, F-94805 Villejuif, France Univ. Paris Sud 11, UMRS 1018, F-94807 Villejuif, France Gustave Roussy, F-94805 Villejuif, France Cancer Control Group, QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia marina.kvaskoff@channing.harvard.edu.
authors.forename: Marina
authors.initials: M
authors.lastname: Kvaskoff
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: Fan
authors.initials: F
authors.lastname: Mu
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Terry
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA Division of Nutritional Epidemiology, The National Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Holly R
authors.initials: HR
authors.lastname: Harris
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Poole
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Farland
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Missmer
mesh_terms: D001249:Asthma / Q000453:epidemiology; D001327:Autoimmune Diseases / Q000453:epidemiology*; D001943:Breast Neoplasms / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002908:Chronic Disease; D004715:Endometriosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology; D008545:Melanoma / Q000453:epidemiology; D010051:Ovarian Neoplasms / Q000453:epidemiology*; D015995:Prevalence; D012306:Risk; D012878:Skin Neoplasms; D016387:Women's Health; D000096142:Cutaneous Malignant Melanoma
keywords: asthma; autoimmune diseases; cancer; cardiovascular diseases; endometriosis