{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:51:31Z","timestamp":1792291891763,"version":"4.4.0"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,9,27]],"date-time":"2017-09-27T00:00:00Z","timestamp":1506470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000589","name":"Chief Scientist Office","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000589","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the long\u2010term risk of further gynaecological surgery and cancer in women with endometriosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Scotland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>281\u00a0937 women with nearly 5\u00a0million person years (4\u00a0923\u00a0628) of follow up from 1981 to 2010.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this national population\u2010based study we compared 17\u00a0834 women with a new surgical diagnosis of endometriosis with 83\u00a0303 women with no evidence of endometriosis at laparoscopy, 162\u00a0966 women who underwent laparoscopic sterilisation, and 17\u00a0834 age\u2010matched women from the general population. Cox proportional hazards regression was used to calculate crude and adjusted hazard ratios with 95% confidence intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Risk of further gynaecological surgery, number and type of repeat surgery and time to repeat surgery from the diagnosis of endometriosis. Cancer outcomes included subsequent risk of all cancer, gynaecological and non\u2013gynaecological cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Women with endometriosis had a significantly higher risk of further surgery when compared with women with no evidence of endometriosis at laparoscopy [hazard ratio (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      ) 1.69, 95% (confidence interval)\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.65\u20131.73], women who had undergone laparoscopic sterilisation (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      3.30, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      3.23\u20133.37) and age\u2010matched women from the general population (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      5.95, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      5.71\u20136.20). They also have an increased risk of ovarian cancer when compared with general population counterparts (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      1.77, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.08\u20132.89) or those with laparoscopic sterilisation (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      1.75, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.2\u20132.45).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Women with surgically diagnosed endometriosis face an increased risk of multiple surgery. They have a higher chance of developing ovarian cancer in comparison with the general population and women with laparoscopic sterilisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Tweetable abstract<\/jats:title>\n                    <jats:p>Women with endometriosis face an increased risk of recurrent surgery and developing ovarian cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.14793","type":"journal-article","created":{"date-parts":[[2017,9,27]],"date-time":"2017-09-27T01:57:20Z","timestamp":1506477440000},"page":"64-72","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":87,"title":["Impact of endometriosis on risk of further gynaecological surgery and cancer: a national cohort study"],"prefix":"10.1111","volume":"125","author":[{"given":"L","family":"Saraswat","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Aberdeen Royal Infirmary Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Ayansina","sequence":"additional","affiliation":[{"name":"Medical Statistics Team University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KG","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Aberdeen Royal Infirmary Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Dugald Baird Centre University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AW","family":"Horne","sequence":"additional","affiliation":[{"name":"MRC Centre for Reproductive Health University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Division of Applied Health Sciences University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det457"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.05.090"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des073"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmp007"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.01.078"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.10.018"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2011.02.008"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2013.01.019"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2015.11.001"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2011.06.017"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2014.00014"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000000454"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200003000-00006"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10370"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23017"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2009.07.1698"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70404-1"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)05203-4"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000164812.02181.d5"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det340"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.299.6704.886"},{"key":"e_1_2_6_23_1","unstructured":"Information Services Division NHS National Services Scotland.Cancer in Scotland.2015[www.isdscotland.org\/Health-Topics\/Cancer\/Publications\/2015-11-17\/Cancer_in_Scotland_summary_m.pdf]. 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