Over the last decade, researchers have become concerned about a possible link between a benign gynecologic lesion called endosalpingiosis and ovarian cancer. However, using a diagnostic method typically reserved for specimens suspected of being cancerous, a team has found the prevalence of endosalpingiosis and other gynecologic lesions was substantially higher than previously reported, even among women without cancer. This higher rate of occurrence led the researchers to believe that endosalpingiosis is not a direct cause of cancer, as previously suspected. Their findings were published by Sunde et al in PLOS ONE.
“Recently, researchers started to wonder if endosalpingiosis could be a precursor to ovarian cancer,” said Jan S. Sunde, MD, Associate Professor and Division Director of Gynecologic Oncology at the Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine, in an institutional press release. “An association of cancer with endosalpingiosis would make endosalpingiosis a concerning finding. But pathologists weren’t reporting benign endosalpingiosis lesions in all surgical cases, and the actual prevalence of endosalpingiosis was unknown.”
Methods and Findings
Dr. Sunde led this research during his time at the Madigan Army Medical Center in Tacoma, Washington. He worked with pathologists there to use a more stringent analysis to determine the actual prevalence of endosalpingiosis in all gynecologic samples—those with cancer and without—at their institution. After implementing the new protocol, the reported prevalence of endosalpingiosis increased from 2.54% to 22.15% in all specimens over a 1-year period. When sorting the data by age group, the researchers found an endosalpingiosis prevalence of 37% in women aged 31 to 50 and 66% in postmenopausal women.
“This is a way more common finding than what people suspected,” said Dr. Sunde. “If endosalpingiosis occurs so frequently, then it likely is not the first step in cancer development, and it’s much less concerning.”
Women with ovarian cancer do have endosalpingiosis at a higher rate, but Dr. Sunde said this could be due to sampling bias. Women with cancer undergo more thorough pathology testing, and studies of endosalpingiosis and cancer do not include a control group of patients with endosalpingiosis and no cancer. Dr. Sunde said further study is needed to determine the true association between endosalpingiosis and cancer.
Next Steps
Next, Dr. Sunde and his team will focus on what conditions allow endosalpingiosis to develop and whether any of those may also be linked to cancer.
“We know there are some benign endosalpingiosis lesions that have the same genetic mutations found in malignant lesions in patients who have an ovarian borderline tumor,” he Sunde. “We hope to find a way to evaluate endosalpingiosis lesions that would tell us if a patient is at risk for developing either borderline or high-grade ovarian cancer. If we figure that out, we can evaluate methods of preventing this deadly cancer.”
Disclosure: For full disclosures of the study authors, visit journals.plos.org.
