Women with endometriosis and uterine fibroids may have a higher long-term risk of premature mortality (death before age 70), particularly from gynecological cancers, according to a recent study.
The large prospective cohort study examined the association between endometriosis, uterine fibroids, and premature mortality. Conducted within the Nurses' Health Study II cohort, the study followed 110,091 women aged 25 to 42 years at baseline in 1989 through 2019, documenting 4,356 premature deaths during 2,994,354 person-years of follow-up.
Researchers found that laparoscopically confirmed endometriosis was associated with a 31% increased risk of premature mortality (hazard ratio [HR], 1.31; 95% confidence interval [CI], 1.20–1.44) after adjusting for potential confounders. Endometriosis was specifically linked to higher mortality from cancer (HR, 1.22; 95% CI, 1.04–1.44), gynecological cancers (HR, 2.76; 95% CI, 1.79-4.26), respiratory diseases (HR, 1.95; 95% CI, 1.11–3.41), and diseases of the nervous system (HR, 2.50; 95% CI, 1.40–4.44). Additionally, mortality from senility and ill-defined diseases was elevated among women with endometriosis (HR, 1.80; 95% CI, 1.19–2.73).
In contrast, uterine fibroids, confirmed by ultrasound or hysterectomy, were not associated with all-cause premature mortality (HR, 1.03; 95% CI, 0.95–1.11). However, they were associated with increased cancer mortality overall (HR, 1.22; 95% CI, 1.07-1.39) and specifically with mortality from gynecological cancers (HR, 2.32; 95% CI, 1.59–3.40). Women with both endometriosis and uterine fibroids exhibited an elevated risk of total premature mortality (HR, 1.31; 95% CI, 1.12–1.53), with an increased risk of cancer mortality observed in this group.
These findings, published in BMJ, highlight the long-term health risks associated with endometriosis and uterine fibroids, particularly regarding gynecological cancers and non-cancer mortality. The researchers emphasize that these findings underscore the importance for primary care providers to consider these gynecological disorders in their assessment of women's health.
Full disclosures can be found in the published study.