Risk for and consequences of endometriosis: A critical epidemiologic review

A L Shafrir; L V Farland; D K Shah; H R Harris; M Kvaskoff; K Zondervan; S A Missmer

doi:10.1016/j.bpobgyn.2018.06.001

Risk for and consequences of endometriosis: A critical epidemiologic review

Best Pract Res Clin Obstet Gynaecol. 2018 Aug:51:1-15. doi: 10.1016/j.bpobgyn.2018.06.001. Epub 2018 Jul 3.

Authors

A L Shafrir¹, L V Farland², D K Shah³, H R Harris⁴, M Kvaskoff⁵, K Zondervan⁶, S A Missmer⁷

Affiliations

¹ Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA; Boston Center for Endometriosis, Boston Children's and Brigham and Women's Hospitals, Boston, MA, USA. Electronic address: amy.shafrir@childrens.harvard.edu.
² Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
³ Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA.
⁴ Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
⁵ CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif Cedex, France; Gustave Roussy, Espace Maurice Tubiana, Villejuif Cedex, France.
⁶ Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN, UK; Endometriosis CaRe Centre, Nuffield Dept of Obstetrics & Gynaecology, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.
⁷ Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA; Boston Center for Endometriosis, Boston Children's and Brigham and Women's Hospitals, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA.

PMID: 30017581
DOI: 10.1016/j.bpobgyn.2018.06.001

Abstract

Endometriosis affects approximately 10% of women of reproductive age. Characteristics robustly associated with a greater risk for endometriosis include early age at menarche, short menstrual cycle length, and lean body size, whereas greater parity has been associated with a lower risk. Relationships with other potential characteristics including physical activity, dietary factors, and lactation have been less consistent, partially because of the need for rigorous data collection and a longitudinal study design. Critical methodologic complexities include the need for a clear case definition; valid selection of comparison/control groups; and consideration of diagnostic bias and reverse causation when exploring demographic characteristics, medical history, and lifestyle factors. Reviewers and editors must demand a detailed description of rigorous methods to facilitate comparison and replication to advance our understanding of endometriosis.

Keywords: Comorbidities; Endometriosis; Epidemiology; Incidence; Risk factors; Study design.

Publication types

Review

MeSH terms

Age Factors
Case-Control Studies
Comorbidity
Endometriosis / diagnosis
Endometriosis / epidemiology
Endometriosis / etiology*
Female
Humans
Incidence
Longitudinal Studies
Menstrual Cycle
Pregnancy
Research Design
Risk Factors