Revisiting the impact of race/ethnicity in endometriosis

Abstract

Endometriosis is a chronic, multisystemic disease often presenting with significant phenotypic variation amongst patients. The impact of race/ethnicity on the prevalence of endometriosis, as well as disease presentation, is a question of interest which has been explored for the last century. This narrative review explores the historical perspective of endometriosis and race/ethnicity as well as the evidence available to date. Furthermore, we discuss the potential implication of the bias perpetuated on this topic, specifically in the areas of medical education, research, and clinical care. In consideration of these intersecting realms, we suggest priorities for future consideration of race/ethnicity as it pertains to the delivery of care for endometriosis patients. Lay summary The relationship between race/ethnicity and endometriosis has been explored for over a century. Historical bias and poorly conducted research have led to the idea that this condition is less likely to be diagnosed in certain racial groups, such as Black women. We review the current state of evidence and highlight important limitations within medical education and research on this topic. Finally, we advocate for a shifting viewpoint as we strive to deliver equitable and outstanding care for all endometriosis patients.