Incidence and Estimated Prevalence of Endometriosis and Adenomyosis in Northeast Italy: A Data Linkage Study

Abstract

Despite being quite frequent and having serious implications in terms of symptomatology and fertility, data on incidence and prevalence of endometriosis and adenomyosis following gold standard definitions are dramatically lacking. The average time from onset of symptoms to diagnosis in industrialized countries still ranges from five to ten years. Using the regional centralized data linkage system, we calculated incidence and prevalence of endometriosis and adenomyosis in the female population of Friuli Venezia Giulia region, Italy, for the years 2011-2013. Cases were defined as new diagnoses from hospital discharge records, following procedures allowing direct visualization for endometriosis and hysterectomy for adenomyosis, with or without histological confirmation. Diagnoses were considered "new" after verifying women had not been diagnosed in the previous ten years. Incidence of endometriosis and adenomyosis in women aged 15-50 years is 0.14%. Prevalence, estimated from incidence, is 2.00%. Adenomyosis, representing 28% of all diagnoses, becomes increasingly prevalent after the age of 50 years. Our results shows how the study of both endometriosis and adenomyosis should not be limited to women of premenopausal age. Further efforts are needed to sensitize women and health professional, and to find new data linkage possibilities to identify undiagnosed cases.

Fig 1. Age-specific incidence of endometriosis and adenomyosis in FVG in the years 2011–2013.

The black line represents incidence of histologically confirmed diagnoses, while the grey line represents incidence of inpatient diagnoses supported by laparoscopy or another surgical procedure allowing direct visualization, regardless of the histological confirmation.

Fig 2. Age-specific prevalence of endometriosis and adenomyosis in FVG in the years 2011–2013.

The black line represents the prevalence of diagnoses based on hysterectomy and histology, while the grey line represents the prevalence of diagnoses supported by hysterectomy, regardless of histological confirmation.