Article

Incidence of endometriosis by study population and diagnostic method: The ENDO study

Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland 20852, USA.
Fertility and sterility (Impact Factor: 4.59). 06/2011; 96(2):360-5. DOI: 10.1016/j.fertnstert.2011.05.087
Source: PubMed

ABSTRACT To estimate the incidence of endometriosis in an operative cohort of women seeking clinical care and in a matched population cohort to delineate more fully the scope and magnitude of endometriosis in the context of and beyond clinical care.
Matched-exposure cohort design.
Surgical centers in the Salt Lake City, Utah, and San Francisco, California, areas.
The operative cohort comprised 495 women undergoing laparoscopy/laparotomy between 2007 and 2009, and the population cohort comprised 131 women from the surgical centers' catchment areas.
None.
Incidence of endometriosis by diagnostic method in the operative cohort and by pelvic magnetic resonance imaged (MRI) disease in the population cohort.
Endometriosis incidence in the operative cohort ranged by two orders of magnitude by diagnostic method: 0.7% for only histology, 7% for only MRI, and 41% for visualized disease. Endometriosis staging was skewed toward minimal (58%) and mild disease (15%). The incidence of MRI-diagnosed endometriosis was 11% in the population cohort.
Endometriosis incidence is dependent on the diagnostic method and choice of sampling framework. Conservatively, 11% of women have undiagnosed endometriosis at the population level, with implications for the design and interpretation of etiologic research.

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    • "Twenty-six women had no diagnostic information stemming from the cancellation of 22 (4%) surgeries or 4 (4%) unreadable MRIs in the operative and population cohorts, respectively, and were excluded from all analyses. Despite their different sampling frameworks, few differences were observed between cohorts (data not shown), with the exception of a higher percentage of married women in the operative than in the population cohort (76% vs. 60%, respectively), as previously reported (Buck Louis et al. 2011). The incidence of surgically visualized endometriosis was 41% in the operative cohort, whereas MRI-visualized endometriosis was 11% in the population cohort. "
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    • "Twenty-six women had no diagnostic information stemming from the cancellation of 22 (4%) surgeries or 4 (4%) unreadable MRIs in the operative and population cohorts, respectively, and were excluded from all analyses. Despite their different sampling frameworks, few differences were observed between cohorts (data not shown), with the exception of a higher percentage of married women in the operative than in the population cohort (76% vs. 60%, respectively), as previously reported (Buck Louis et al. 2011). The incidence of surgically visualized endometriosis was 41% in the operative cohort, whereas MRI-visualized endometriosis was 11% in the population cohort. "
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