Background: Endometriosis is a chronic gynaecological disorder affecting approximately 10% of premenopausal women. Although endometriosis is a benign disease, it shares characteristics of malignant cells such as local and distant metastasis and the ability to invade tissue and destroy it. The sequelae of endometriosis being considered a pre-neoplastic disease are grave. They would mandate a reappraisal of the current long-term management of endometriosis.

Methods & Results: A literature review of the current evidence linking endometriosis to cancer was performed. Epidemiological studies; cohort and case-control studies identified are mainly retrospective in nature but link endometriosis to an increased long-term risk of ovarian cancer.  Furthermore, molecular-genetic studies have identified a common genetic mutation occurring in both cells of epithelial ovarian cancers and endometriotic cells. The suggestion is that certain types of epithelial ovarian tumours arise through a continuum sequential stage during tumour progression of endometriotic cells.

Conclusion: The evidence in the literature so far highlights a potential link between endometriosis and ovarian epithelial tumours. However, the epidemiological studies are mainly retrospective, incurring potential for bias. As for the bio-molecular evidence presented, it is in its early stages and further studies are needed to determine how the earlier genetic mutations contribute to the transformation from an endometriotic cell to a malignant one. This presentation will endeavor to provide a recommendation as to how to counsel and proceed when your patient enquires about cancer risk.