{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:11:54Z","timestamp":1780549914592,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T00:00:00Z","timestamp":1657584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Increasing awareness of endometriosis in adolescents requires data on the nature of the disease and its management. Our objective was to investigate the subtypes of surgically confirmed endometriosis in adolescents (aged &lt;20\u2009years) and trends in the incidence rates and endometriosis\u2010related procedures during the study period, 1987\u20132012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>In this register\u2010based cohort study, we identified 526 adolescents receiving their initial surgical diagnosis of endometriosis between 1987 and 2012 from the Finnish Hospital Discharge Register. The age\u2010specific incidence rate of surgically confirmed endometriosis was calculated by dividing the number of adolescents during specific periods by person\u2010years. We calculated the relative differences in incidence rates between the periods using crude incidence ratios.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Adolescents were divided into three age groups, &lt;17, 17\u201318, and 19\u2009years, which comprised 8.2% (43\/526), 39.7% (209\/526), and 52.1% (274\/526) of the study cohort, respectively. Peritoneal endometriosis and ovarian endometriosis were the most common types (379\/526 [72%] and 119\/526 [23%], respectively). The incidence rate of surgically confirmed endometriosis per 100\u2009000 person\u2010years varied from 5.63 (95% confidence interval [CI] 4.24\u20137.33) to 11.42 (95% CI 9.64\u201313.44). The incidence rate in 2001\u20132005 was significantly higher and was 1.6\u2010 to 2.0\u2010fold that of the periods 1987\u20131990 and 2006\u20132012, respectively. Comparing the periods in which <jats:italic>International Classification of Diseases, Ninth Revision<\/jats:italic> (ICD\u20109; 1987\u20131995) and <jats:italic>Tenth Revision<\/jats:italic> (ICD\u201010; 1996\u20132012) codes were used, the use of laparoscopy (78.2% vs 88.9%), day surgery (10.3% vs 31.6%), and procedures for ovarian (18.8% vs 34.1%) and deep (0.6% vs 10.8%) endometriosis increased. The types of endometriosis and procedures did not differ between the age groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Peritoneal endometriosis was the most common type of endometriosis overall and by age group. During the 26\u2010year period, the incidence rate of initial surgical diagnosis of endometriosis peaked in 2001\u20132005 and decreased thereafter. The proportion of procedures performed for ovarian and deep endometriosis increased, as did the use of laparoscopy and day surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14419","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T10:36:28Z","timestamp":1657622188000},"page":"1065-1073","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Surgically confirmed endometriosis in adolescents in Finland\u2014A register\u2010based cross\u2010sectional cohort study"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1611-3037","authenticated-orcid":false,"given":"Elina","family":"Rasp","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8002-0789","authenticated-orcid":false,"given":"Liisu","family":"Saavalainen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"But","sequence":"additional","affiliation":[{"name":"Biostatistics consulting, Department of Public Health University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare (THL)  Helsinki Finland"},{"name":"Academic Primary Health Care Center Region Stockholm  Stockholm Sweden"},{"name":"Department of Molecular Medicine and Surgery Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4ivi","family":"H\u00e4rkki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8671-130X","authenticated-orcid":false,"given":"Oskari","family":"Heikinheimo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6344-1159","authenticated-orcid":false,"given":"Kristiina","family":"R\u00f6n\u00f6","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2013.255"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2018-00242"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1810764"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00389-5"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14711"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16447"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-012-2361-z"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoac009"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2020.07.011"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2015.07.001"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1083-3188(03)00063-9"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dew174"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2019.12.004"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13244"},{"key":"e_1_2_11_16_1","unstructured":"World Health Organization2022 Adolescent health. 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