Global disparities found in endometriosis care guidance

An analysis has found significant geographical gaps in endometriosis care guidance worldwide.

The condition affects an estimated 190 million women globally, with research indicating a gap of up to 12 years between symptom onset and diagnosis.

It has also been identified as one of the main causes of a 75 million disability-adjusted life-year gender health gap, a measure that quantifies years lost to illness, disability or premature death.

The scoping review, a broad mapping of available guidance, assessed availability across 194 World Health Organization-defined countries through bibliographic searches and grey literature reviews.

After screening, researchers identified 143 unique sources for care guidance across 141 countries, so 27 per cent of WHO-defined countries had no identifiable guidance related to care.

Only New Zealand and Peru had both professional society and government guidance, placing them at the highest level of the researchers’ ranking.

In contrast, news media was the highest available source of guidance for 12 per cent of countries.

Regional differences were stark.

All European countries had some level of care guidance, while 32 African countries had none, despite 21 of these having a specific society or advocacy group.

The study investigators wrote: “Many people who are affected by endometriosis might benefit from centres of expertise with multidisciplinary specialist care.

“However, there are many potential socioeconomic, geographical, and clinical barriers to reaching these specialist services.”

Meanwhile, surgical technology is being used to improve diagnosis.

Megan Wasson, chair of gynaecology at Mayo Clinic, noted that visual recognition and training are vital, as the condition often varies in appearance.

Advances in laparoscopy (keyhole surgery) and robotic surgery have improved magnification, helping clinicians identify atypical presentations.

Wasson said: “Being able to really zoom in on these lesions and see the difference in normal versus abnormal peritoneum is incredibly helpful.”