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. 2025 Jan;132(2):118-130.
doi: 10.1111/1471-0528.17973. Epub 2024 Oct 7.

Time to Diagnose Endometriosis: Current Status, Challenges and Regional Characteristics-A Systematic Literature Review

Pauline De Corte  1 , Moritz Klinghardt  1 , Sophia von Stockum  1 , Klaas Heinemann  1
Affiliations

Time to Diagnose Endometriosis: Current Status, Challenges and Regional Characteristics-A Systematic Literature Review

Pauline De Corte et al. BJOG. 2025 Jan.

Erratum in

Abstract

Background: Endometriosis diagnosis reportedly faces delays of up to 10 years. Despite growing awareness and improved guidelines, information on the current status is limited.

Objectives: To systematically assess the published evidence on the status of time to diagnosis in individuals with endometriosis, with respect to the definition of time to diagnosis, geographical location and patient characteristics.

Search strategy: MEDLINE (via PubMed) and Embase were searched for publications reporting time to diagnosing endometriosis since 2018. No restrictions to population or comparators were applied. All publications were screened by two independent reviewers.

Selection criteria: Search results were limited to primary publications of randomised controlled trials, non-randomised trials and observational studies. Case reports, secondary publications and grey literature were excluded. No restrictions were made regarding language, provided that an English title and abstract were available.

Data collection and analysis: Publications were assessed with respect to time to diagnosis, diagnostic methods, study type, study country and potential bias.

Main results: The 17 publications eligible for inclusion in this literature review were all observational studies. The publications reported diagnosis times between 0.3 and 12 years, with variations depending on the definition of time to diagnosis (overall, primary, or clinical), geographical location and characteristics of the included study population. Evidence was of poor to good quality overall.

Conclusions: Diagnostic delay is still present, primarily driven by physicians, and this review underscores the need for standardised definitions, increased awareness and targeted diagnostic interventions.

Keywords: diagnostic delay; endometriosis; time to diagnosis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of search process and study selection according to PRISMA guidelines. Multiple reasons allowed. 1A: Population (i.e., persons not diagnosed with endometriosis); 2B: Intervention (i.e., publications with and without interventions that do not allow an assessment of diagnosis time); 3C: Outcome (i.e., publications that do not allow an assessment of diagnosis time); 4D: Study type (i.e., case reports); 5Several records reporting on the same study results.
FIGURE 2
FIGURE 2
Diagnosis time distributions per country and publication included in this systematic review. The average time to diagnosis is presented as the mean. Instances where the median diagnosis time is reported are marked with an asterisk (*).
See this image and copyright information in PMC

References

    1. Davenport S., Smith D., and Green D. J., “Barriers to a Timely Diagnosis of Endometriosis: A Qualitative Systematic Review,” Obstetrics and Gynecology 142, no. 3 (2023): 571–583. - PubMed
    1. Zale M., Lambert E., LaNoue M. D., and Leader A. E., “Shedding Light on Endometriosis: Patient and Provider Perspectives on a Challenging Disease,” Journal of Endometriosis and Pelvic Pain Disorders 12, no. 2 (2020): 69–76.
    1. Frayne J., Milroy T., Simonis M., and Lam A., “Challenges in Diagnosing and Managing Endometriosis in General Practice: A Western Australian Qualitative Study,” Australian Journal of General Practice 52, no. 8 (2023): 547–555. - PubMed
    1. Matsuzaki S., Canis M., Pouly J.‐L., Rabischong B., Botchorishvili R., and Mage G., “Relationship Between Delay of Surgical Diagnosis and Severity of Disease in Patients With Symptomatic Deep Infiltrating Endometriosis,” Fertility and Sterility 86, no. 5 (2006): 1314–1316. - PubMed
    1. Dmowski W. P., Lesniewicz R., Rana N., Pepping P., and Noursalehi M., “Changing Trends in the Diagnosis of Endometriosis: A Comparative Study of Women With Pelvic Endometriosis Presenting With Chronic Pelvic Pain or Infertility,” Fertility and Sterility 67, no. 2 (1997): 238–243. - PubMed

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