Polycystic ovary syndrome increases the risk of endometrial cancer in women aged less than 50 years: an Australian case–control study
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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.
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 randomly 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.
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.
These data extend existing findings, including adjustment for confounders, suggesting PCOS is a risk factor for endometrial cancer.
KeywordsEndometrium Cancer Androgen Polycystic ovary syndrome Case–control study
The Australian National Endometrial Cancer Study was supported by the National Health and Medical Research Council (NHMRC) of Australia (#339435) and Cancer Council Tasmania (#403031 and 457636). AB Spurdle and PM Webb are both funded by Senior Research Fellowships from the NHMRC. We thank all of the women who participated in the study and Paul Fahey, Catherine Olsen, Sarah Messiah, David Preen, David Slaney and Steve Weinstein for early discussions contributing to this work. We gratefully acknowledge the cooperation of the following institutions: NSW: John Hunter Hospital, Liverpool Hospital, Mater Misericordiae Hospital (Sydney), Mater Misericordiae Hospital (Newcastle), Newcastle Private Hospital, North Shore Private Hospital, Royal Hospital for Women, Royal Prince Alfred Hospital, Royal North Shore Hospital, Royal Prince Alfred Hospital, St George Hospital; Westmead Hospital, Westmead Private Hospital; Qld: Brisbane Private Hospital, Greenslopes Hospital, Mater Misericordiae Hospitals, Royal Brisbane and Women’s Hospital, Wesley Hospital, Queensland Cancer Registry; SA: Adelaide Pathology Partners, Burnside Hospital, Calvary Hospital, Flinders Medical Centre, Queen Elizabeth Hospital, Royal Adelaide Hospital, South Australian Cancer Registry; Tas: Launceston Hospital, North West Regional Hospitals, Royal Hobart Hospital; Vic: Freemasons Hospital, Melbourne Pathology Services, Mercy Hospital for Women, Royal Women’s Hospital, Victorian Cancer Registry; WA: King Edward Memorial Hospital, St John of God Hospitals Subiaco & Murdoch, Western Australian Cancer Registry.
Conflict of interest
The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
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