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Surgically confirmed endometriosis in adolescents in Finland—A register‐based cross‐sectional cohort study
INTRODUCTION: 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 <20 years) and trends in the incidence rates and endometriosis...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812065/ https://www.ncbi.nlm.nih.gov/pubmed/35818936 http://dx.doi.org/10.1111/aogs.14419 |
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author | Rasp, Elina Saavalainen, Liisu But, Anna Gissler, Mika Härkki, Päivi Heikinheimo, Oskari Rönö, Kristiina |
author_facet | Rasp, Elina Saavalainen, Liisu But, Anna Gissler, Mika Härkki, Päivi Heikinheimo, Oskari Rönö, Kristiina |
author_sort | Rasp, Elina |
collection | PubMed |
description | INTRODUCTION: 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 <20 years) and trends in the incidence rates and endometriosis‐related procedures during the study period, 1987–2012. MATERIAL AND METHODS: In this register‐based 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‐specific incidence rate of surgically confirmed endometriosis was calculated by dividing the number of adolescents during specific periods by person‐years. We calculated the relative differences in incidence rates between the periods using crude incidence ratios. RESULTS: Adolescents were divided into three age groups, <17, 17–18, and 19 years, 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 100 000 person‐years varied from 5.63 (95% confidence interval [CI] 4.24–7.33) to 11.42 (95% CI 9.64–13.44). The incidence rate in 2001–2005 was significantly higher and was 1.6‐ to 2.0‐fold that of the periods 1987–1990 and 2006–2012, respectively. Comparing the periods in which International Classification of Diseases, Ninth Revision (ICD‐9; 1987–1995) and Tenth Revision (ICD‐10; 1996–2012) 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. CONCLUSIONS: Peritoneal endometriosis was the most common type of endometriosis overall and by age group. During the 26‐year period, the incidence rate of initial surgical diagnosis of endometriosis peaked in 2001–2005 and decreased thereafter. The proportion of procedures performed for ovarian and deep endometriosis increased, as did the use of laparoscopy and day surgery. |
format | Online Article Text |
id | pubmed-9812065 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98120652023-01-05 Surgically confirmed endometriosis in adolescents in Finland—A register‐based cross‐sectional cohort study Rasp, Elina Saavalainen, Liisu But, Anna Gissler, Mika Härkki, Päivi Heikinheimo, Oskari Rönö, Kristiina Acta Obstet Gynecol Scand Gynecology INTRODUCTION: 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 <20 years) and trends in the incidence rates and endometriosis‐related procedures during the study period, 1987–2012. MATERIAL AND METHODS: In this register‐based 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‐specific incidence rate of surgically confirmed endometriosis was calculated by dividing the number of adolescents during specific periods by person‐years. We calculated the relative differences in incidence rates between the periods using crude incidence ratios. RESULTS: Adolescents were divided into three age groups, <17, 17–18, and 19 years, 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 100 000 person‐years varied from 5.63 (95% confidence interval [CI] 4.24–7.33) to 11.42 (95% CI 9.64–13.44). The incidence rate in 2001–2005 was significantly higher and was 1.6‐ to 2.0‐fold that of the periods 1987–1990 and 2006–2012, respectively. Comparing the periods in which International Classification of Diseases, Ninth Revision (ICD‐9; 1987–1995) and Tenth Revision (ICD‐10; 1996–2012) 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. CONCLUSIONS: Peritoneal endometriosis was the most common type of endometriosis overall and by age group. During the 26‐year period, the incidence rate of initial surgical diagnosis of endometriosis peaked in 2001–2005 and decreased thereafter. The proportion of procedures performed for ovarian and deep endometriosis increased, as did the use of laparoscopy and day surgery. John Wiley and Sons Inc. 2022-07-12 /pmc/articles/PMC9812065/ /pubmed/35818936 http://dx.doi.org/10.1111/aogs.14419 Text en © 2022 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Gynecology Rasp, Elina Saavalainen, Liisu But, Anna Gissler, Mika Härkki, Päivi Heikinheimo, Oskari Rönö, Kristiina Surgically confirmed endometriosis in adolescents in Finland—A register‐based cross‐sectional cohort study |
title | Surgically confirmed endometriosis in adolescents in Finland—A register‐based cross‐sectional cohort study |
title_full | Surgically confirmed endometriosis in adolescents in Finland—A register‐based cross‐sectional cohort study |
title_fullStr | Surgically confirmed endometriosis in adolescents in Finland—A register‐based cross‐sectional cohort study |
title_full_unstemmed | Surgically confirmed endometriosis in adolescents in Finland—A register‐based cross‐sectional cohort study |
title_short | Surgically confirmed endometriosis in adolescents in Finland—A register‐based cross‐sectional cohort study |
title_sort | surgically confirmed endometriosis in adolescents in finland—a register‐based cross‐sectional cohort study |
topic | Gynecology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812065/ https://www.ncbi.nlm.nih.gov/pubmed/35818936 http://dx.doi.org/10.1111/aogs.14419 |
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