Trends in prevalence and incidence of endometriosis in a large population-based study in Catalonia (Spain) from 2009 to 2018

Abstract

Introduction: Endometriosis highly impacts women's health and quality of life. However, research on the prevalence and incidence of endometriosis is still scarce and inconclusive. This study assesses time trends in the prevalence and incidence of endometriosis diagnosis in Catalonia (Spain) from 2009 to 2018, and differences by age and socioeconomic status. Methods: Population-based cohort study using data from the Information System for Research in Primary Care (SIDIAP) database. Data from more than 2.4 million women aged 15-55 between 01/01/2006 and 31/12/2018 were included. Results: 2,337,717 women were selected as the incident population; 0.7% had an endometriosis diagnosis. Median [IQR] age at diagnosis was 37 [32, 43]. Most of these women were European (92.3%) and lived in urban areas (73.6%). Overall prevalence of endometriosis consistently increased in the 2009-2018 period and it was 1.24% in 2018. Trends were the highest for women with less socioeconomic deprivation and for the 35-44 age group. Median incidence rates were 94.9 [92.6, 102.9] per 100,000 women-year, being the highest in women aged 35-44 throughout the whole study period. Overall, incidence increased between 2015 and 2017, and plateaued or decreased in 2018. Incidence rates in women from most deprived and rural areas were lower, although incidence time trends by socioeconomic status were unclear. Conclusions: Healthcare services and public health strategies need to be strengthened to ensure endometriosis timely diagnosis and treatment. Special attention should be paid to the most affected populations and social inequities of health.