Polycystic ovary syndrome increases the risk of endometrial cancer in women aged less than 50 years: an Australian case–control study Endometrial carcinoma; ovarian dysfunction--a risk factor in young women. Epithelial Ovarian Cancer Risk Among Women With Polycystic Ovary Syndrome Women younger than 50 years with endometrial cancer. Infertility‐Associated Endometrial Cancer Risk May Be Limited to Specific Subgroups of Infertile Women
Objective Although polycystic ovary syndrome ( PCOS ) is commonly cited as a risk factor for endometrial cancer , supporting epidemiological evidence is currently very limited . Our aim was to assess the associations between PCOS , PCOS symptoms , and  risk of endometrial cancer in women aged less than 50 years . Methods Data came from a national population -based case – control study in Australia . Cases with newly diagnosed histologically confirmed endometrial cancer were identified through treatment clinics and cancer registries Australia wide . Controls were r and omly selected from the national electoral roll . Women were interviewed about their reproductive and medical history , including self-reported PCOS , and lifestyle . Current analyses were restricted to women aged under 50 ( 156 cases , 398 controls ) . We estimated odds ratios ( OR ) using logistic regression to adjust for confounding factors . Results Women with PCOS had a fourfold increased risk of endometrial cancer compared to women without PCOS ( OR 4.0 , 95 % CI 1.7–9.3 ) . This association was attenuated when additionally adjusted for body mass index ( OR 2.2 , 95 % CI 0.9–5.7 ) . Risk was slightly greater when restricted to Type I cancers . PCOS symptoms including hirsutism and very irregular periods were significantly associated with endometrial cancer risk . Conclusions These data extend existing findings , including adjustment for confounders , suggesting PCOS is a risk factor for endometrial cancer From a referral area comprising one-fifth of the Swedish female population we investigated possible risk factors for endometrial cancer ( EC ) in different age groups . Seventy-seven women aged 31 - 45 with EC were collected retrospectively , and 99 women aged 46 - 65 were consecutively collected . Both groups were compared to referents r and omly selected from a population based study from the city of Göteborg . The referents consisted of 1746 women aged 39 - 65 years . All cases were studied by hospital record and 82 % of the women aged 31 - 45 years and 85 % of those aged 46 - 65 years were studied by an extensive question naire . Among the referents 1409 ( 81 % ) were investigated by the above-mentioned question naire . Hirsutism , increased body mass index ( BMI ) and hypertension were significantly more common in both EC groups compared to referents . Nulliparity and infertility were significantly more common in the young EC group . Referents used combined oral contraceptives  significantly more often than women developing EC . There was , however , no difference between the groups with respect to the duration of medication with combined oral contraceptives . There was a significant negative correlation between cigarette smoking and the development of EC . These findings indicate that untreated ovarian dysfunction like that present in polycystic ovarian disease ( PCO ) with unopposed estrogen action on the endometrium is associated with EC in younger women , and that smoking may protect against EC by an ' anti-estrogenic ' effect Objective To investigate the relationship between polycystic ovary syndrome ( PCOS ) and ovarian cancer , and to present three hypotheses regarding hormonal factors and the risk of ovarian cancer in women . Methods Data were analyzed from a population -based , case-control study , the Cancer and Steroid Hormone Study , to test the hypotheses . Four hundred seventy-six subjects with histologically confirmed epithelial ovarian cancer were identified from eight tumor registries of the Surveillance Epidemiology and End Results program . The study included 4081 controls ascertained via r and om-digit telephone dialing . All subjects and controls were aged 20 - 54 years . Results Seven subjects with ovarian cancer and 24 controls reported that they had been diagnosed with PCOS before the study period . Ovarian cancer risk was found to increase 2.5-fold ( 95 % confidence interval [ CI ] 1.1 - 5.9 ) among women with PCOS . This association is found to be stronger among women who never used oral contraceptives ( odds ratio [ OR ] 10.5,95 % CI 2.5 - 44.2 ) and women who were in the first quartile of body mass index ( 13.3 - 18.5 kg/m2 ) at age 18 ( OR 15.6 , 95 % CI 3.4 - 71.0 ) . Conclusion The data suggest that the hormonal status of women with PCOS featuring abnormal patterns of gonado-tropic secretion ( enhanced levels of LH ) in lean women may be a mitigating factor for the observed association between PCOS and ovarian cancer . We hope that our preliminary data stimulate further investigation of the testable hypotheses PURPOSE OF INVESTIGATION The purpose of the study was to evaluate if known risk factors for endometrial cancer in menopausal women are also related to endometrial cancer in younger ages . METHODS Eighty-one patients with a mean age of 46.3 years diagnosed with endometrial cancer ( EC ) ( histologically confirmed ) from January of 1992 to December of 2004 were included in the study . The  EC  group of patients was compared with  100 patients ( control group ) r and omly selected from the gynecologic clinic ( inclusion criteria : age 43 - 48 years ) without any endometrial cancer diagnoses that were evaluated for the same factors . RESULTS Mean BMI was 34.4 kg/m2 ( SD = 8.8 ) in the first group and 28.3 ( SD = 7.6 ) in the second one ( p < 0.001 ) . None of the women in the EC group reported any history of oral contraception . With the exception of hypertension and ovarian cancer ( probably related to small numbers ) all other comparisons were statistically significant ( although some only marginally ) . DISCUSSION From the results of our study , it seems that body mass index ( BMI ) , parity , type of menstrual cycles , history of polycystic ovarian ( PCO ) syndrome and diabetes are possibly related to endometrial cancer in women younger than 50 years of age , and the strongest relation was found with increased BMI . Also , there was no increased incidence of hypertensive disease in the EC group . CONCLUSION Prospect i ve studies are needed for final conclusions Data from previous studies suggest that infertility is a risk factor for endometrial cancer . We used data from the Cancer and Steroid Hormone Study to further characterize this relationship . The subject group comprised 399 women ages 20–54 with newly diagnosed epithelial endometrial cancer ascertained through six cancer registries . The control group comprised 3040 women in the same age range selected by r and om-digit telephone dialing from the same geographic areas where cancer patients resided . Compared with women who reported no fertility problem , women with physician-diagnosed infertility who had reported at least 2 years of infertility had an odds ratio for endometrial cancer , adjusted for age , of 1.7 ( 95 % confidence interval 1.1–2.6 ) . Women who reported infertility result ing from ovarian factors had an adjusted odds ratio of 4.2 ( 95 % confidence interval 1.7–10.4 ) . These results suggest that factors such as anovulation may explain much of the increased risk of endometrial cancer found among subgroups of infertile women
BACKGROUND Polycystic ovary syndrome ( PCOS ) is a common condition affecting ∼8 % of women .
The objective of the present study was to quantify separately the risk of endometrial cancer , ovarian cancer and breast cancer in women with PCOS compared with non-PCOS controls , and quantify separately the risk to women of all ages as well as the risk to premenopausal women .