French Cohort Analysis Shows Diagnostic Delays in Endometriosis and Adenomyosis

The ComPaRe-Endometriosis e‑cohort, a prospective French patient cohort of approximately 6,950 participants with self-reported endometriosis and/or adenomyosis, reported mean diagnostic delays of 10 years for endometriosis and 11 years for adenomyosis.

Investigators drew the analytic sample from the Community of Patients for Research (ComPaRe)-Endometriosis prospective e‑cohort in France and evaluated correlates of diagnostic delay using linear regression models adjusted for age, education level, body mass index, number of comorbidities, and family history of the disease or chronic pelvic pain.

Unemployment was associated with an additional 0.7 years of delay, while each additional comorbidity was associated with a 0.3-year increase. A family history of endometriosis or chronic pelvic pain was associated with a 1.1-year longer delay. On the symptom and care-pathway side, severe dysmenorrhea before diagnosis was associated with an additional 0.8 years, each additional health professional consulted before diagnosis was associated with a 0.3-year increase per provider, and presenting with multiple symptoms at the first consultation was associated with a 1.6-year longer delay.

Perceiving one’s financial position as comfortable was associated with a 1.4-year shorter delay, older age at menarche was associated with a 0.6-year reduction, and older age at first symptoms was associated with a 0.8-year shorter delay.

Key Takeaways:

• The ComPaRe-Endometriosis cohort reported mean diagnostic delays of 10 years for endometriosis and 11 years for adenomyosis.
• Longer delay was associated with unemployment, higher comorbidity count, family history of endometriosis or chronic pelvic pain, severe prediagnosis dysmenorrhea, consulting more health professionals, and presenting with multiple symptoms.
• Shorter delay was associated with perceived comfortable financial position, older age at menarche, and older age at first symptoms, and the authors concluded delay remained substantial and was influenced by socioeconomic and clinical factors.