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Fertil Steril. 2011 Aug;96(2):360-5. doi: 10.1016/j.fertnstert.2011.05.087. Epub 2011 Jun 29.

Incidence of endometriosis by study population and diagnostic method: the ENDO study.

Author information

1
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. louisg@mail.nih.gov

Abstract

OBJECTIVE:

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.

DESIGN:

Matched-exposure cohort design.

SETTING:

Surgical centers in the Salt Lake City, Utah, and San Francisco, California, areas.

PATIENT(S):

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.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Incidence of endometriosis by diagnostic method in the operative cohort and by pelvic magnetic resonance imaged (MRI) disease in the population cohort.

RESULT(S):

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.

CONCLUSION(S):

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.

PMID:
21719000
PMCID:
PMC3143230
DOI:
10.1016/j.fertnstert.2011.05.087
[Indexed for MEDLINE]
Free PMC Article

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