Evidence map›Paper›PMID 40802078›Full record

ArticleDiscover oncology2025

Anatomic subtype-specific causal effects of endometriosis on ovarian cancer: a two-sample Mendelian randomization study.

Xu Zhang, Li Wang, Xingxing Ruan, Jie Ding, Jing Wan, Chengfang Xu, Xiaomao Li

Abstract read
In one paragraph

Article in Discover oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Xu Zhang *Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China.
Li Wang *Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China.
Xingxing RuanDepartment of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China.
Jie DingDepartment of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China.
Jing WanDepartment of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China.
Chengfang Xu *Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China. xuchengf@mail.sysu.edu.cn.
Xiaomao Li *Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China. lixmao@mail.sysu.edu.cn.

Funding

Guangdong Provincial Key Laboratory of Human Digital Twin 2022B1212010004
6 · The paper itself

Abstract

While epidemiological studies have associated endometriosis with ovarian cancer risk, the causal relationships across anatomic subtypes and histotypes remain undefined. Using two-sample Mendelian randomization with 84 genetic instruments (F-statistic = 30.01-228.09), we analyzed genome-wide data from 20,190 endometriosis cases and 25,509 ovarian cancer patients. Genetically proxied endometriosis significantly increased risks of overall ovarian cancer [OR = 1.18, 95% confidence interval (95%CI): 1.10-1.28), high-grade serous (OR:1.12, 95% CI 1.01-1.23), clear cell (OR:1.87, 95% CI 1.44-2.43), and endometrioid carcinomas (OR:1.48, 95% CI 1.30-1.69)]. Anatomic subtype analyses revealed differential effects. Pelvic peritoneal lesions showed the highest risk for clear cell carcinoma (OR = 1.81, 95% CI 1.52-2.16). Deep endometriosis broadly impacted high-grade serous (OR = 1.10, 95% CI 1.04-1.17) and endometrioid carcinomas (OR = 1.25, 95% CI 1.13-1.40). Ovarian endometriosis specifically elevated clear cell (OR = 1.65, 95% CI 1.46-1.86) and endometrioid risks (OR = 1.48, 95% CI 1.30-1.69;). Rectovaginal lesions selectively increased endometrioid carcinoma risk (OR = 1.25, 95% CI 1.04-1.51). No associations were emerged between any type of endometriosis for low-grade serous or invasive mucinous ovarian. Significant heterogeneity was detected in ovarian endometriosis-mucinous cancer associations persisting after MR-PRESSO outlier correction, while other associations retained consistent effect sizes post-adjustment. Funnel plot symmetry, leave-one-out stability, and MR-Egger intercept collectively confirmed result robustness without directional pleiotropy. This study provides novel evidence that endometriosis causally increases risk of specific ovarian cancer histotypes, particularly demonstrating that anatomic subtypes represent distinct etiological entities with differential oncogenic potential, where pelvic peritoneal lesions emerge as a previously underappreciated high-risk subtype for clear cell carcinoma development, thereby offering critical insights for refining risk stratification protocols and guiding targeted surveillance strategies in clinical practice.

Indexed as

Causal inferenceEndometriosis subtypesGenetic epidemiologyMendelian randomizationOvarian cancer histotypes

Identifiers

PMID40802078
PMCPMC12350920

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.