Endometriosis is a growth of endometrial stroma on the outside of the uterus and affects approximately 10% of women. Symptomology of endometriosis is characterized by pain, dysmenorrhea, dyspareunia and infertility. Research papers on endometriosis can focus on any aspect of the disorder such as:
- Approximate diagnostic age of a woman with Endometriosis
- Treatments for Endometriosis
- Pathology of Endometriosis
A number of risk factors are associated with the development of Endometriosis. A small percentage, 5 – 10%, of all Endometriosis is hereditary. Women who possess mutations in the BRCA1 or BRCA2 genes are at higher risk. Additionally, higher risk is conferred to women with a family history of hereditary breast or ovarian cancer syndrome, Lynch II syndrome, which is a form of colon cancer, or certain mutations in genes responsible for DNA repair. Reproductive factors play a role in ovarian Endometriosis. Early onset of menstruation, late onset of menopause, infertility, and lack of at least one pregnancy place women at higher risk. Conversely, breastfeeding and oral contraceptives offer a protective affect. Research also suggests that a diet high in fat or coffee, or low in vitamin A or fiber, place women at increased risk for Endometriosis. Finally, environmental exposure may also play a role, with increased risk associated with talc use, asbestos, radiation, and viral infections such as rubella or mumps.
Endometriosis, in relation to cancer, spurs on the following testing. Transvaginal sonography (TVS) is often used in conjunction with another screening method called CA125. CA125, or cancer antigen 125, is a protein produced by cancerous ovarian cells whose level, along with morphological information obtained through TVS, can be predictive of malignancy. Levels of this protein are elevated in 50% of stage 1 ovarian cancer patients and 90% of those with higher stage ovarian cancers. While a simple blood test for the protein can be used to detect preclinical ovarian cancer prior to the appearance of symptoms, it is not an effective diagnostic agent by itself due to its low degree of specificity; other gynecological tissues, benign and malignant, can also produce elevated levels of this protein. For example, in premenopausal women, events such as menstruation and endometriosis can result in inflammation, which in turn results in increased levels of CA 125. Thus, this method of detection is problematic in younger women still experiencing such events (Rosenthal & Jacobs, 2006). Additionally, only 50% of stage 1 ovarian cancers are associated with elevated CA125 levels, a high percentage of patients with disease have elevated CA125 levels that revert back to normal levels, and this protein marker provides no information regarding tumor localization. In-depth statistical studies of CA 125 levels and stages of ovarian cancer have revealed that the consideration of patient age along with the rate of change of CA125 levels, in addition to its absolute level, is a more sensitive and specific method for determining ovarian cancer risk as as result of Endometriosis.