Long and irregular menstrual cycles, polycystic ovary syndrome, and ovarian cancer risk in a population‐based case‐control study

Harris, Holly R.; Titus, Linda; Cramer, Daniel W.; Terry, Kathryn L.

doi:10.1002/ijc.30441

Cited by 79 publications

(61 citation statements)

References 49 publications

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“…[ 5 ] No association between PCOS and ovarian cancer was evident in cohort studies conducted in Taiwan and England. [ 17 , 22 ] Oral contraceptive use can reduce the risk of ovarian cancer. [ 23 ] Thus, patients with PCOS are typically treated with oral contraceptives according to the guidelines that suggest that OCs may counteract the potential cancer-promoting effects of PCOS.…”

Section: Discussionmentioning

confidence: 99%

Association between polycystic ovarian syndrome and endometrial, ovarian, and breast cancer

Ding

Chen

Wang³

et al. 2018

Medicine

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Polycystic ovary syndrome (PCOS) is a common endocrine disorder among the women of reproductive age. We conducted a nationwide population-based retrospective cohort study to analyze the association between PCOS and the subsequent development of gynecological cancers, namely endometrial, breast, and ovarian cancer.For this population-based cohort study, we used the Taiwan National Health Insurance Research Database, which contains information on approximately 24.7 million insured individuals. The cohort included women who had received a diagnosis of PCOS between 1998 and 2013. An age-matched systematic random-sampling method with a ratio of 1:4 was used for patient selection for the non-PCOS reference cohort. Multivariate Cox proportional hazard regression analysis was used to determine the effects of PCOS on the risks of gynecologic and breast cancer. The data are presented as hazard ratios (HRs) with 95% confidence intervals (CIs).The PCOS cohort consisted of 8155 patients with PCOS, and the comparison cohort consisted of 32,620 matched patients without PCOS. The incidence of endometrial cancer was 226 and 15 per 100,000 person-years in the PCOS and comparison groups, respectively. A statistically significant higher risk of endometrial cancer was found in the PCOS cohort (adjusted HR [aHR] = 17.7, 95% CI = 4.9–64.2) than in the comparison cohort. However, no association was observed between PCOS and ovarian (aHR = 1.64, 95% CI: 0.63–4.27) or breast cancer (aHR = 0.98, 95% CI: 0.58–1.65).The results of this large population-based cohort study supported the premise that women with PCOS might have an increased risk of endometrial cancer, but no association between PCOS and the risks of ovarian and breast cancer was found.

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Section: Discussionmentioning

confidence: 99%

Association between polycystic ovarian syndrome and endometrial, ovarian, and breast cancer

Ding

Chen

Wang³

et al. 2018

Medicine

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“…These associations with endometrial cancer may be most relevant to the endometrioid or clear cell EOC, given endometrial tissue is a proposed tissue of origin for these subtypes. PCOS itself has not consistently been associated with ovarian cancer (43, 44, 47), though data by subtype are limited. Data to date suggest both estrogen-alone and estrogen plus progesterone HT are associated with increased risk of endometrioid EOC (18).…”

Section: Discussionmentioning

confidence: 99%

Androgens Are Differentially Associated with Ovarian Cancer Subtypes in the Ovarian Cancer Cohort Consortium

et al. 2017

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Invasive epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy. The etiology of EOC remains elusive; however, experimental and epidemiologic data suggest a role for hormone-related exposures in ovarian carcinogenesis and risk factor differences by histologic phenotypes and developmental pathways. Research on pre-diagnosis androgen concentrations and EOC risk has yielded inconclusive results, and analyses incorporating EOC subtypes are sparse. We conducted a pooled analysis of 7 nested case-control studies in the Ovarian Cancer Cohort Consortium to investigate the association between pre-diagnosis circulating androgens (testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS)), sex hormone binding globulin (SHBG), and EOC risk by tumor characteristics (i.e. histology, grade, and stage). The final study population included 1,331 EOC cases and 3,017 matched controls. Multivariable conditional logistic regression was used to assess risk associations in pooled individual data. Testosterone was positively associated with EOC risk (all subtypes combined, Odds Ratio (OR)log2=1.12 [95% Confidence Interval (CI) 1.02–1.24]); other endogenous androgens and SHBG were not associated with overall risk. Higher concentrations of testosterone and androstenedione associated with an increased risk in endometrioid and mucinous tumors (e.g., testosterone, endometrioid tumors, ORlog2=1.40 [1.03–1.91]), but not serous or clear cell. An inverse association was observed between androstenedione and high grade serous tumors (ORlog2=0.76 [0.60–0.96]). Our analyses provide further evidence for a role of hormone-related pathways in EOC risk, with differences in associations between androgens and histologic subtypes of EOC.

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“…Irregular menstrual cycles, a hallmark of polycystic ovary syndrome, have been associated with higher androgen and lower sex hormone binding globulin levels. This abnormal hormonal environment may also increase the risk of specific histologic subtypes of ovarian cancer [48].…”

Section: Biologic Clocks and Reproductionmentioning

confidence: 99%

Using Circadian Rhythm Patterns of Continuous Core Body Temperature to Improve Fertility and Pregnancy Planning

Webster

Smarr

2020

Journal of Circadian Rhythms

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Objective: Review relationships among circadian clocks, core body temperature (CBT), and fertility in women. Methods: Scoping literature review. Results: Circadian clocks are a ubiquitous adaptation to the most predictable environmental events-the daily cycles of light and dark. Core body temperature (CBT) also follows a circadian rhythm. Additionally, CBT is tightly controlled by a combination of neuronal circuits that begin in the hypothalamus and involve many other portions of the brain as well as a wide range of peripheral mechanisms. In women with normal reproductive function, the diurnal temperature pattern for CBT is strongly influenced by the menstrual cycle of reproductive hormones, primarily estradiol and progesterone, which modulate the activity of hypothalamic neural circuits involved in body temperature control, resulting in an infradian CBT rhythm. Conclusions: Analysis of CBT via continuous recording reveals patterns in the interactions of circadian and infradian CBT rhythms capable of accurately predicting the fertility window and hormonal patterns suggesting oligo-ovulation and subfertility. New wearable technologies can facilitate employment of hormone-associated changes in CBT for pregnancy planning and offer clinical insight to infertility and menopause.

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Long and irregular menstrual cycles, polycystic ovary syndrome, and ovarian cancer risk in a population‐based case‐control study

Cited by 79 publications

References 49 publications

Association between polycystic ovarian syndrome and endometrial, ovarian, and breast cancer

Association between polycystic ovarian syndrome and endometrial, ovarian, and breast cancer

Androgens Are Differentially Associated with Ovarian Cancer Subtypes in the Ovarian Cancer Cohort Consortium

Using Circadian Rhythm Patterns of Continuous Core Body Temperature to Improve Fertility and Pregnancy Planning

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