Key Facts
- Endometriosis is linked to a real, measurable increase in ovarian cancer risk, but the absolute risk for most women with endometriosis remains low.
- A 2024 JAMA study of more than 78,000 women found endometriosis overall was associated with more than 4 times the risk of ovarian cancer, which translates to about 10 additional cases per 10,000 women.
- Risk varies significantly by subtype. Deep infiltrating endometriosis and ovarian endometriomas carried roughly 9 times the risk, while superficial endometriosis carried less.
- Despite this, routine ovarian cancer screening (ultrasound, CA-125 blood testing) is still not recommended for women with endometriosis. No screening approach has been shown to reduce mortality, and false positives carry real harms.
- The clearest evidence-based action available today: discuss opportunistic salpingectomy, removal of the fallopian tubes, at the time of any pelvic surgery you already need. A 2026 study found it reduced serous ovarian cancer risk by roughly 78%.
- Dr. Kim has personally published peer-reviewed research on the adoption and safety of salpingectomy for ovarian cancer risk reduction.
If you have endometriosis, it is important to understand how it links to ovarian cancer. Fortunately, this link varies by the type of endometriosis you have, and the absolute risk for most women stays low.
What Is the Real Link Between Endometriosis and Ovarian Cancer?
A team led by Dr. Karen Schliep at the University of Utah studied more than 78,000 women with endometriosis, ages 18 to 55, against a matched group of nearly 380,000 women without it, using the Utah Population Database. Roughly 600 women across both groups developed ovarian cancer (Barnard et al., JAMA, 2024).
Women with endometriosis had more than 4 times the risk of ovarian cancer overall, translating to about 10 additional cases per 10,000 women. Most of that increase came from type I ovarian cancer, a slower-growing, less symptomatic form, where women with endometriosis had 7.5 times the risk.
Does Your Type of Endometriosis Change Your Cancer Risk?
Yes, substantially, and it lines up with how endometriosis is already categorized on a detailed evaluation for endometriosis:
- Superficial peritoneal endometriosis, small lesions on the pelvic lining, carried the smallest risk increase of the three subtypes.
- Deep infiltrating endometriosis and ovarian endometriomas (“chocolate cysts”) carried roughly 9 times the risk. Among these more severe subtypes, the risk of type I cancer specifically was almost 19 times greater than in women without endometriosis.
Not all endometriosis carries the same risk, and knowing your subtype is directly relevant to understanding your own numbers, not just your pain.
How Worried Should You Actually Be?
This is where relative risk numbers can mislead without context. Ovarian cancer is uncommon in the general population: a woman’s lifetime risk is about 1 in 91, or roughly 1.1% (American Cancer Society). Multiplying a low baseline by 4 or even 9 still produces a risk most women with endometriosis will never experience firsthand.
This is also new research. The JAMA study was published in July 2024, and its authors note that further study in larger, more diverse populations is needed before it changes formal screening or prevention guidelines. It is important data to know, not a reason to assume the worst.
Should You Be Screened for Ovarian Cancer If You Have Endometriosis?
Currently, no. Even with this new data, the U.S. Preventive Services Task Force and the Society of Gynecologic Oncology recommend against routine ovarian cancer screening, ultrasound or the CA-125 blood test, in women at average or moderately increased risk. The largest randomized trial to test this, UKCTOCS, found screening did not reduce ovarian cancer deaths, and false-positive results led to unnecessary surgeries.
What is worth doing instead is an honest conversation with your gynecologist about your specific subtype, your family history, and whether genetic counseling makes sense if you also have a personal or family history of breast or ovarian cancer.
Symptoms to Watch For If You Have Endometriosis
Endometriosis pain typically tracks your menstrual cycle. Ovarian cancer symptoms tend to behave differently. Per the American Cancer Society, the symptoms worth watching are:
- Bloating
- Pelvic or abdominal pain
- Difficulty eating or feeling full quickly
- Urinary urgency or frequency
These symptoms are concerning when they are new, occur more than 12 times a month, or last more than a few weeks, rather than rising and falling with your period the way endometriosis pain usually does.
Can You Minimize Your Risk of Ovarian Cancer?
Most serous ovarian cancers, the most lethal subtype, are now understood to originate in the fallopian tubes rather than the ovaries. This has led to opportunistic salpingectomy: removing the fallopian tubes, while leaving the ovaries and their hormone production intact, during a pelvic surgery you already need, such as endometriosis excision surgery or a hysterectomy.
A 2026 study from the Ovarian Cancer Observatory, a British Columbia-based research collaboration, found opportunistic salpingectomy reduced the risk of serous ovarian cancer by approximately 78% compared with hysterectomy or tubal ligation alone (JAMA Network Open, 2026).
Dr. Kim has personally published peer-reviewed research on exactly this shift in practice. Her 2019 study found that after the SGO and ACOG began recommending salpingectomy for ovarian cancer prevention, its use for sterilization rose from under 10% to 78% of procedures at the hospitals studied, with no increase in surgical complications versus conventional tubal ligation (Kim et al., Journal of Minimally Invasive Gynecology, 2019).
If you are already scheduled for pelvic surgery for endometriosis and are finished with childbearing, this is a concrete question to bring to your surgeon, not a separate procedure to seek out on its own.
Book a Consultation with Dr. Annie Kim
If you have endometriosis and want a clear, individualized understanding of your risk, including your specific subtype and whether opportunistic salpingectomy makes sense for you, Dr. Kim offers a thorough evaluation on the Upper East Side. Schedule a consultation to talk through your options directly.
Frequently Asked Questions About Endometriosis and Cancer
Does endometriosis cause ovarian cancer?
Endometriosis is associated with an increased risk of ovarian cancer, particularly type I cancers, but most women with endometriosis never develop it. The relationship is a risk association, not a direct cause.
Which type of endometriosis carries the highest cancer risk?
Deep infiltrating endometriosis and ovarian endometriomas carry roughly 9 times the risk of superficial peritoneal endometriosis, which carries the smallest increase of the three subtypes.
Should I get an ultrasound or CA-125 test because I have endometriosis?
Current guidelines recommend against routine ovarian cancer screening for women at average or moderately increased risk, since it has not been shown to reduce mortality and can lead to unnecessary surgery from false positives.
What is opportunistic salpingectomy?
It is the removal of the fallopian tubes, where most serous ovarian cancers originate, during a pelvic surgery you already need. It leaves the ovaries in place and has been shown to meaningfully reduce ovarian cancer risk.
What symptoms should prompt me to call my doctor?
New or persistent bloating, pelvic pain, early satiety, or urinary urgency that occurs more than 12 times a month or lasts several weeks, especially if it does not follow your usual cycle pattern.
Medically reviewed by Annie Kim, MD. Last updated: August 2026