Abstract

To assess and synthesize the existing evidence on the association between pelvic inflammatory disease (PID) and the risk of ovarian cancer. Methods: A total of 388 pertinent publications were found after a comprehensive search across four databases. 47 full-text publications were examined after duplicates were eliminated using Rayyan Qatar Computing Research Institute (QCRI) and relevance was checked; four studies finally satisfied the requirements for inclusion. Results: We included six studies with a total of 349,034 women diagnosed or with a history of PID. While some studies suggest that PID, particularly infections caused by Chlamydia trachomatis and HSV-2, may contribute to the development of epithelial ovarian cancer (EOC) and borderline ovarian tumors (BOT), others report no significant connection, especially with high-grade serous carcinoma (HGSC). One study identifies PID as an independent risk factor, with women having a 1.49-fold higher likelihood of developing ovarian cancer. In contrast, other findings indicate no increased incidence of ovarian cancer associated with PID. Conclusion: This review highlights a complex and inconsistent relationship between PID and ovarian cancer risk. While chronic inflammation caused by Chlamydia trachomatis and HSV-2 infections may play a role, some studies report no significant associations, particularly with subtypes like HGSC. Early diagnosis and treatment of PID remain crucial to minimize long-term complications. Larger, well-designed prospective studies are needed to clarify PID’s role in ovarian carcinogenesis. Identifying high-risk populations and incorporating PID history into cancer risk models could improve early detection and prevention strategies.

Key words: Pelvic Inflammatory Disease, Ovarian Cancer, Chronic Inflammation, Systematic review.