Skip to main content
Lotus Endometriosis Institute solid color logo
A beautiful landscape of lotus flowers

Evaluating Cancer Risk in Endometriosis

What the evidence says about links to ovarian, breast, thyroid, and cervical cancers—and practical steps to understand and reduce your risk

By Dr Steven Vasilev
Three‑quarter vector scene of a person at a home desk checking off a color‑coded screening plan with icons for ovarian, breast, thyroid, and cervical health, reflecting evidence‑based prevention steps.

Understanding the Connection Between Endometriosis and Cancer Risk


Endometriosis is not cancerous, but it can exhibit cancer-like behavior by invading tissues and organs or spreading through the lymphatic and blood systems. Research suggests potential molecular links between endometriosis and specific cancers, grounded in genetics and epigenetics (the study of how environmental factors influence gene activity). Overall, the risk of developing certain cancers appears to be slightly increased in women with endometriosis. Additional studies indicate that adenomyosis, a closely related condition, may also be associated with a heightened risk. The reasons remain unclear, though molecular connections are being uncovered, and the degree of risk varies by cancer type.


Endometriosis and Cancer Risk Transformation


Cells from endometriosis can directly transform or degenerate into cancer. The types identified are clear cell, endometrioid, and, more rarely, stromal sarcoma. The exact percentage is unknown due to under-reporting of both endometriosis and these transformation events, but estimates suggest it is only a fraction of 1%. While this fraction is small, the large number of people affected by endometriosis means that tens of thousands may still be at risk.


Endometriosis and Ovarian Cancer Risk


Endometriosis has been linked to an increased risk of developing certain types of ovarian cancer. Studies show that those with endometriosis are more likely to develop clear cell and endometrioid ovarian cancers than those without the condition, with the risk estimated at 1.5 to 3 times higher. The risk is highest when the ovaries are significantly involved, such as with endometriomas.


The mechanisms behind this association are not fully understood, but chronic inflammation and scarring associated with endometriosis may promote cancerous mutations or epigenetic events in cells. Although the risk is increased, most people with endometriosis will not develop ovarian cancer. Still, as with direct malignant transformation, even a small percentage translates to thousands to tens of thousands of affected individuals when considering the overall number of people with endometriosis.


Endometriosis and Thyroid Cancer


Multiple studies consistently report a smaller but statistically significant 1.4-fold higher risk of thyroid cancer in people with endometriosis. The cause is unknown, though some researchers propose a shared autoimmune foundation connecting endometriosis, thyroid disease, and cancer.


Endometriosis and Breast Cancer


Evidence suggests a very small association between endometriosis and breast cancer, with an approximately 4% increased risk. Some studies indicate a somewhat higher risk. However, this association is not as well established as the relationship with ovarian cancer, and further research is needed for confirmation.


Worried About Cancer Risk?

Our specialists are here to help you understand your condition and explore your treatment options.

Schedule Your Checkup

Endometriosis and Cervical Cancer


Unlike ovarian and breast cancer, there is no clear link between endometriosis and cervical cancer. A handful of studies even suggest a reduced risk in people with endometriosis, though the reason for this is unknown.


Endometriosis and Other Cancer Risks


While an association with uterine endometrial cancer might be expected, evidence is mixed. A recent meta-analysis reported no increased risk, whereas other studies have found a significantly increased risk in those with endometriosis and adenomyosis. Findings are also conflicting for colorectal cancer; skin cancers, including melanoma; leukemia; lymphoma; urinary cancers; and gastric or liver cancer. Notably, several studies reported no increased colon cancer risk, but one study suggested the risk might be as high as thirteen-fold.


At-a-Glance Summary of Reported Cancer Risks

Cancer type

Reported relationship with endometriosis

Magnitude/detail

Ovarian (clear cell, endometrioid)

Increased risk

1.5–3 times higher; highest with ovarian involvement such as endometriomas

Thyroid 

Increased risk 

1.4-fold higher

Breast

Slightly increased risk

About 4% higher; some studies suggest somewhat higher

Cervical

No clear link; possibly reduced risk

Reduced risk suggested in a handful of studies |

Uterine endometrial

Mixed evidence

Meta-analysis suggests no risk; other studies report significantly increased risk (especially with adenomyosis)

Colorectal

Conflicting findings

Many studies show no increase; one study reports up to thirteen-fold risk

Skin (including melanoma), leukemia, lymphoma

Conflicting findings

No consensus on increased risk

Urinary, gastric, liver

Conflicting findings

No consensus on increased risk


Managing Your Endometriosis and Cancer Risk


If you have endometriosis, staying informed about potential cancer risks and taking proactive steps can be helpful. Consider regular cancer screening appropriate for your age and personal risk factors, maintain a healthy lifestyle, and discuss any concerns with your doctor. A genetically founded increased risk may be present in some individuals, so if cancer and/or endometriosis runs in your family, consulting an expert may be best. If you are older and have endometriosis, it may also be advisable to seek expert consultation. Awareness and proactive care are valuable, and it is equally important to remember that although risk may be increased, most people with endometriosis will not develop cancer.

References

  1. Kvaskoff M, Mahamat-Saleh Y, Farland LV, Shigesi N, Terry KL, Harris HR, Roman H, Becker CM, As-Sanie S, Zondervan KT, Horne AW, Missmer SA. Endometriosis and cancer: a systematic review and meta-analysis. Hum Reprod Update. 2021 Feb 19;27(2):393-420. doi: 10.1093/humupd/dmaa045. PMID: 33202017.

Quick Answers

How do I make the most of a short endometriosis appointment?

Go in with a one-page snapshot of your story so the limited time is spent on decision-making, not backtracking. The most helpful snapshot includes: your top 2–3 symptoms, the pattern (cyclical vs daily, triggers, where pain starts and spreads), what you’ve already tried and what happened, and what your symptoms keep you from doing (work, school, intimacy, exercise). If you have a history of “normal” scans, bring that too—because imaging can miss endometriosis, and the pattern of symptoms and prior response to treatment still matters.


Bring the right records if you have them—especially operative reports, pathology, and imaging reports (and ideally the actual images). Then decide your goal for the visit: diagnostic clarity, a plan to evaluate look-alike or coexisting conditions, or a clear surgical discussion (whether surgery is likely to help, anticipated scope, and what recovery may involve). If you want to make the appointment count even more, reach out to our team ahead of time so we can review what you’ve already done and tell you exactly what information would be most useful for a focused, productive conversation.

Read full answer

Can endometriosis cause inflammation-related weight gain?

Yes—there can be a connection, but it’s usually not as simple as “inflammation makes you gain fat.” Endometriosis is an inflammatory condition, and that inflammation can drive fluid shifts, pelvic and abdominal swelling, bowel slowing/constipation, and the classic waxing-and-waning “endo belly,” all of which can look and feel like weight gain even when body fat hasn’t changed. Pain, fatigue, and stress can also reduce activity or change appetite patterns, which can indirectly affect body composition over time.


What’s also emerging in research is a possible link between endometriosis and certain metabolic risk patterns in some people (like central waist changes and lipid markers). That doesn’t prove endometriosis directly causes metabolic changes—or that metabolic changes cause endometriosis—but it does support why some patients feel their body is harder to “regulate” while the disease is active. If weight changes, bloating, or a new shift in your waistline is part of your story, our team can help you sort out what’s most likely inflammation and GI distension versus longer-term metabolic or hormonal contributors, and build a plan that aligns with your symptoms and goals. If you’d like, you can reach out to schedule a consultation so we can evaluate the full picture and discuss treatment options, including excision and coordinated whole-person care.

Read full answer

Can endometriosis cause a pulling or tugging sensation?

Yes—endometriosis can cause a pulling, tugging, or “stuck” sensation in the pelvis or lower abdomen. This often comes from inflammation and fibrosis (scar-like tissue) that can tether organs to each other or to the pelvic sidewall, so movements like standing upright, stretching, twisting, bowel movements, or sex may feel like something is being pulled.


That pulling sensation can also show up alongside other endometriosis patterns—pain that worsens around your period or ovulation, deep pain with intercourse, bowel or bladder pain, or a feeling of pressure and heaviness. Because endometriosis can involve many structures (including bowel, bladder, ureters, and deeper pelvic tissues), the exact “tug” you feel can hint at where disease may be affecting anatomy and nerves.


If you’re noticing this symptom, we encourage you to track when it happens (cycle timing, specific movements, bowel/bladder activity) and what else comes with it—those details help us map likely sources and plan a targeted evaluation. When appropriate, minimally invasive excision surgery can both confirm the diagnosis (with biopsy) and remove tethering disease to relieve symptoms—reach out to schedule a consultation with our team to talk through your history and options.

Read full answer

Can endometriosis qualify as a disability?

Yes—endometriosis can qualify as a disability in some situations, but it isn’t “automatically” considered one in every case. When symptoms like pelvic pain, fatigue, bowel/bladder pain, or pain with sex significantly limit day-to-day functioning, a person may be protected under the Americans with Disabilities Act (ADA) and may be eligible for workplace accommodations.


For Social Security disability benefits, endometriosis is not a listed condition, so approval typically depends on showing how your symptoms and functional limitations prevent you from sustaining work. Documentation matters: clear diagnosis details, treatment history (including surgery and symptom management), and records describing how often symptoms flare and what activities they limit. If you’re navigating work or disability questions, our team can help evaluate the medical side of your case, clarify the disease versus pain mechanisms (including central sensitization), and create a plan that supports both symptom control and long-term treatment goals—reach out to schedule a consultation.

Read full answer

Will an endometriosis surgeon take me seriously if I don’t want kids?

Yes. Your symptoms and quality of life matter—full stop—and your goals don’t have to include pregnancy for you to deserve thorough evaluation and effective treatment. In our practice, we don’t use fertility as a “gatekeeper” for care; we focus on what your disease may be doing (pain, bleeding, bowel/bladder symptoms, fatigue, missed work, intimacy pain) and what outcomes you want from treatment.


Not wanting children can actually make some options clearer, especially when adenomyosis or severe uterine disease is part of the picture, because fertility-preserving constraints may not apply. That said, we still individualize planning—endometriosis can involve multiple organs, and the right surgical approach is about complete, precise excision and a plan you understand, not a one-size-fits-all recommendation.


If you’ve felt dismissed before, you’re not alone. Our intake and consult process is designed to be record-based and purposeful so we can take your history seriously, set expectations early, and be direct about whether we think we can help. If you’re ready, reach out to schedule a consultation and tell us your goals clearly—including if your priority is pain relief and long-term function rather than fertility.

Read full answer

Reach Out

Have a question?

Dr. Steven Vasilev delivers best-in-class endometriosis guidance and a personalized treatment plan—built on evidence and your unique biology.


Led by Steven Vasilev, MD—an internationally recognized endometriosis specialist & MIGS surgeon—Lotus Endometriosis Institute is virtual-forward, with many patients traveling nationally for care. Clinical evaluation and surgical treatment are provided in California.

Santa Monica, CA

2121 Santa Monica Blvd, Santa Monica, CA 90404

Operating Hours

8:00 am - 5:00 pm
Monday - Friday

Arroyo Grande, CA

154 Traffic Way, Arroyo Grande, CA 93420