Endometriosis and Ovarian Cancer: Balancing Risk, Prevention, and Fertility

For clinicians managing patients with endometriosis, the established link to ovarian cancer presents a distinct challenge [1, 2]. While the condition is associated with an increased relative risk of developing ovarian cancer, particularly clear cell and endometrioid histotypes [3, 4, 5], the absolute risk for any individual patient remains low. Data indicate an odds ratio of 1.82 and a standardized incidence ratio of 1.62 for overall ovarian cancer in women with endometriosis [4], yet the absolute lifetime risk is estimated at only 1.9% [6]. This discrepancy between relative and absolute risk requires a nuanced management approach, compelling physicians to balance preventive strategies against the potential harms of intervention [7]. A recent review synthesizes current epidemiological, molecular, and clinical evidence to help guide these complex decisions in daily practice [6].