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Danazol Use for Endometriosis Linked to Ovarian Cancer Risk

Originally published by Reuters Health, March 18, 2002

NEW YORK (Reuters Health) — Beyond the known risk of ovarian cancer associated with endometriosis, the use of danazol to treat the condition appears to increase the risk further, according to a report presented at the 33rd annual meeting of the Society of Gynecologic Oncologists in Miami.

“Among women with endometriosis, the use of danazol, but not leuprolide is associated with a significant increased risk of ovarian cancer,” Dr. Roberta B. Ness from the University of Pittsburgh Graduate School of Public Health, told Reuters Health.

There is a theory that androgens may play a role in the genesis or mediation of ovarian cancer, Dr. Ness said. Danazol is a weak androgen, while leuprolide is an antiandrogen, she explained.

Dr. Ness and colleagues pooled data on 1373 women with ovarian cancer and 1980 age-matched controls from two case-control studies done between 1993 and 1999. Among these women, 195 cases and 195 controls had endometriosis. Of these women, eight cases and seven controls were treated with leuprolide and 12 cases and 5 controls were treated with danazol, Dr. Ness’ team reports.

After adjusting for gravidity, oral contraceptive use, education and family history of ovarian cancer, endometriosis was associated with a 1.5-fold increase in ovarian cancer. The odds ratio for ovarian cancer was 3.6 for women treated with danazol but only 1.4 for those treated with leuprolide.

“Given these new preliminary data, and since there are alternatives to danazol for treating endometriosis, I would suggest caution in using danazol as a first-line agent,” Dr. Ness said.