Infertility and ovarian cancer risk: Evidence from nine prospective cohort studies

Jiang, Yuting; Gong, Ting-Ting; Zhang, Jiayu; Li, Xiuqin; Gao, Song; Zhao, Yuhong; Wu, Qi‐Jun

doi:10.1002/ijc.33012

Cited by 13 publications

(9 citation statements)

References 45 publications

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“…High SDI regions are more severe than other regions, and East Asia has the highest burden of disease. This is associated with social and economic development, maternal number and the decrease of breastfeeding, infertility and the increase in obesity is the promoting factors of ovarian cancer [ 25 – 27 ], but fortunately, with the progress of treatment technology in recent years, and the active involvement of patients in treatment, The mortality rate of OC in these regions continued to decrease. In contrast, we found a significant increase in most developing countries.…”

Section: Discussionmentioning

confidence: 99%

The global burden and associated factors of ovarian cancer in 1990–2019: findings from the Global Burden of Disease Study 2019

et al. 2022

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Background Ovarian cancer (OC) is a major cause of cancer-related deaths among women. The aim of this study was to estimate and report data on the current burden of ovarian cancer worldwide over the past 30 years. Method Based on the data provided by GBD 2019, we collected and interpreted the disease data of ovarian cancer by incidence, mortality, disability-adjusted life-years (DALYs), and used corresponding age-standardized rates as indicators. Also, we categorized the data by attributed risk factors and captured deaths due to high fasting plasma glucose, occupational exposure to asbestos and high body-mass index, respectively. All outcomes in the study were reported using mean values and corresponding 95% uncertainty intervals (95% UI). Results Globally, there were 294422 (260649 to 329727) incident cases in 2019, and the number of deaths and DALYs were 198412 (175357 to 217665) and 5.36 million (4.69 to 5.95). The overall burden was on the rise, with a percentage change of 107.8% (76.1 to 135.7%) for new cases, 103.8% (75.7 to 126.4%) for deaths and 96.1% (65.0 to 120.5%) for DALYs. Whereas the age-standardized rates kept stable during 1990–2019. The burden of ovarian cancer increased with age. and showed a totally different trends among SDI regions. Although high SDI region had the declining rates, the burden of ovarian cancer remained stable in high-middle and low SDI regions, and the middle and low-middle SDI areas showed increasing trends. High fasting plasma glucose was estimated to be the most important attributable risk factor for ovarian cancer deaths globally, with a percentage change of deaths of 7.9% (1.6 to 18.3%), followed by occupational exposure to asbestos and high body mass index. Conclusions Although the age-standardized rates of ovarian cancer didn’t significantly change at the global level, the burden still increased, especially in areas on the lower end of the SDI range. Also, the disease burden due to different attributable risk factors showed heterogeneous, and it became more severe with age.

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Section: Discussionmentioning

confidence: 99%

The global burden and associated factors of ovarian cancer in 1990–2019: findings from the Global Burden of Disease Study 2019

et al. 2022

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“…In addition to the item Control for important factors or additional factors, each study could be given every item a maximum of one star. These studies, which obtained full stars in at least two classifications of selection, comparability, or outcome assessment, were classified as low risk of having bias (29,30).…”

Section: Data Extraction and Quality Assessmentmentioning

confidence: 99%

Post-Diagnostic Beta Blocker Use and Prognosis of Ovarian Cancer: A Systematic Review and Meta-Analysis of 11 Cohort Studies With 20,274 Patients

et al. 2021

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ObjectivesPrevious experimental studies have indicated that exposure to beta blocker provides protective effects against ovarian cancer (OC). However, findings from epidemiologic studies have still been controversial. Therefore, we carried out a meta-analysis to update and quantify the correlation between post-diagnostic beta blocker usage and OC prognosis.MethodsThe meta-analysis had been registered at PROSPEPO. The number of registration is CRD42020188806. A comprehensive search of available literatures in English prior to April 16, 2020, was conducted in PubMed, EMBASE, and the Web of Science databases. Random-effects models were used to calculate overall hazard ratios (HRs) and 95% confidence intervals (CIs). Publication bias assessments, and subgroup, sensitivity, and meta-regression analyses were also performed.ResultsOf the 637 initially identified articles, 11 retrospective cohort studies with 20,274 OC patients were included. The summary HRs did not reveal any statistically significant associations between post-diagnostic beta blocker use and OC prognosis characteristics, such as total mortality (HR = 1.08, 95% CI = 0.92–1.27, I2 = 76.5%, n = 9), cancer-specific mortality (HR = 1.22, 95% CI = 0.89–1.67, I2 = 88.1%, n=3), and progression-free survival (HR = 0.88, 95% CI = 0.75–1.05, I2 = 0, n = 4). No evidence of publication bias was observed in current analysis. In our subgroup analyses, the majority of results were consistent with the main findings. However, several positive correlations were detected in studies with ≥800 cases (HR = 1.20, 95% CI = 1.05–1.37), no immortal time bias (HR = 1.28, 95% CI = 1.10–1.49), and adjustment for comorbidity (HR = 1.20, 95% CI = 1.05–1.37). In the meta-regression analysis, no evidence of heterogeneity was detected in the subgroups according to study characteristics and confounding factors.ConclusionsPost-diagnostic beta blocker use has no statistical correlation with OC prognosis. More prospective cohort studies are necessary to further verify our results.Systematic Review RegistrationIdentifier (CRD42020188806).

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“…Rodriguez et.al previously found that infertility itself might increase ovarian cancer risk without concomitant exposure to OI drugs [ 82 ]. A current meta-analysis based on nine prospective cohort studies also suggested that infertility in women was associated with an increased risk of ovarian cancer [ 83 ]. Moreover, a number of diseases that cause infertility, including polycystic ovary syndrome (PCOS) and endometriosis, had been found to be associated with ovarian cancer development.…”

Section: Discussionmentioning

confidence: 99%

Ovulation induction drug and ovarian cancer: an updated systematic review and meta-analysis

Sun

Wang

et al. 2023

J Ovarian Res

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Objective To explore the association between ovulation induction drugs and ovarian cancer. Design Systematic review and meta-analysis. Setting Not applicable. Patient(s) Women without ovarian cancer who ever or never underwent ovarian induction. Intervention(s) An extensive electronic search of the following databases was performed: PubMed, EMBASE, MEDLINE, Google Scholar, Cochrane Library and CNKI, from inception until January 2022. A total of 34 studies fulfilled our inclusion criteria and were included in the final meta-analysis. The odds ratio (OR) and random-effects model were used to estimate the pooled effects. The Newcastle-Ottawa Scale was used to assess the quality of included studies. Funnel plots and Egger tests were used to assess publication bias. Main outcomes New diagnosed borderline ovarian tumor (BOT) and invasive ovarian cancer (IOC) between ovulation induction (OI) group and control (CT) group considering fertility outcome, OI cycles and specific OI drugs. Results Primarily, there was no significant difference in the incidence of IOC and BOT between the OI and CT groups. Secondly, OI treatment did not increase the risk of IOC and BOT in the multiparous women, nor did it increase the risk of IOC in the nulliparous women. However, the risk of BOT appeared to be higher in nulliparous women treated with OI treatment. Thirdly, among women exposed to OI, the risk of IOC and BOT was higher in nulliparous women than in multiparous women. Fourthly, the risk of IOC did not increase with increasing OI cycles. Lastly, exposure to specific OI drugs also did not contribute to the risk of IOC and BOT. Conclusion Overall, OI treatment did not increase the risk of IOC and BOT in most women, regardless of OI drug type and OI cycle. However, nulliparous women treated with OI showed a higher risk of ovarian cancer, necessitating their rigorous monitoring and ongoing follow-up.

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Infertility and ovarian cancer risk: Evidence from nine prospective cohort studies

Cited by 13 publications

References 45 publications

The global burden and associated factors of ovarian cancer in 1990–2019: findings from the Global Burden of Disease Study 2019

The global burden and associated factors of ovarian cancer in 1990–2019: findings from the Global Burden of Disease Study 2019

Post-Diagnostic Beta Blocker Use and Prognosis of Ovarian Cancer: A Systematic Review and Meta-Analysis of 11 Cohort Studies With 20,274 Patients

Ovulation induction drug and ovarian cancer: an updated systematic review and meta-analysis

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