Mortality risk associated with endometriosis: a systematic review and meta-analysis

Endometriosis is a chronic, estrogen-dependent gynecological disorder affecting approximately 10% of women worldwide that can cause pelvic pain, lead to infertility, and impair quality of life. Whether the condition elevates risk of mortality remains controversial. This systematic literature review and meta-analysis investigated the long-term survival of women with endometriosis.

Studies reporting mortality among women with endometriosis were identified through PubMed, EMBASE, Web of Science, Scopus, and OpenGrey in accordance with PRISMA recommendations. Pooled data on all-cause mortality and mortality for specific diseases were meta-analyzed using a random-effects model. Heterogeneity was evaluated using the I² statistic.

Women with endometriosis were not at significantly higher risk than the general population of women for mortality related to gynecological cancer (HR 1.56, 95% CI 0.72-3.39), non-cancerous cardiocerebral disease (HR 0.80, 95% CI 0.53-1.23), non-cancerous respiratory disease (HR 0.89, 95% CI 0.20-4.02), accidents/suicide (HR 1.33, 95% CI 0.99-1.79) or all causes combined (HR 1.00, 95% CI 0.82-1.21).

Endometriosis does not appear to increase risk of all-cause mortality or mortality due to specific diseases. Future research should focus on how interventions or management influence other long-term outcomes, such as quality of life and mental and reproductive health.