Polycystic ovary syndrome increases the risk of endometrial cancer in women aged less than 50 years: an Australian case-control study.
ABSTRACT 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.
- SourceAvailable from: Philippa T K Saunders
[Show abstract] [Hide abstract]
- "PCOS and EC share many of the same risk factors and a recent population-based case-control study in 135 Australia found that women with PCOS have a four-fold increased risk of EC compared to women without PCOS (Fearnley, et al. 2010). This risk was elevated for type 1 cancers and had a greater association with symptoms of androgen excess such as hirsutism (OR 2.4, all EC cases) and irregular periods (OR 3.1, all EC cases) (Fearnley et al. 2010). "
ABSTRACT: Endometrial and ovarian cancers are common gynecological malignancies. The impact of androgen action in these cancers is poorly understood however there is emerging evidence to suggest that targeting androgen signalling may be of therapeutic benefit. Epidemiological evidence suggests that there is an increased risk of endometrial cancer associated with exposure to elevated levels of androgens and genetic variants in genes related to both androgen biosynthesis and action are associated with increased risk of both endometrial and ovarian cancer. Androgen receptors may be a potential therapeutic target in endometrial cancer due to reported anti-proliferative activities of androgens. In contrast, androgens may promote growth of some ovarian cancers and anti-androgen therapy has been proposed. Introduction of new therapies targeting androgen receptors expressed in endometrial or ovarian cancers will require a much greater understanding of the impacts of cell context-specific androgen receptor-dependent signalling and how androgen receptors can cross-talk with other steroid receptors during progression of disease. This review considers the evidence that androgens may be important in the aetiology of endometrial and ovarian cancers with discussion of evidence for androgen action in normal and malignant endometrial and ovarian tissue.Endocrine Related Cancer 03/2014; 21(4). DOI:10.1530/ERC-13-0551 · 4.91 Impact Factor
[Show abstract] [Hide abstract]
- "In addition, endometrial estrogen production in cancer cells might amplify the effect of estrogens naturally produced in the ovaries and delivered via the circulation. been reported that PCOS women with endometrial hyperplasia have a four times greater risk of developing EC than non-PCOS women . Although women with PCOS have an increased risk of developing EC , the risk is not the same in all women as evidenced by the fact that not all women with PCOS develop EC and not all women with EC suffer from PCOS. "
ABSTRACT: Endometrial cancer (EC) is the most common gynecological malignancy in women and is the leading cause of cancer-related deaths worldwide. Estrogenic stimulation significantly increases endometrial cell proliferation, and both insulin resistance and hyperinsulinemia are associated with the development of EC in women. It has long been known that insulin resistance occurs in women with polycystic ovary syndrome (PCOS) and/or obesity, but one important unanswered question is whether the insulin resistance associated with PCOS and obesity is part of the etiology of the initiation and development of EC. Therefore, research efforts to understand the common and specific underlying endometrial responses to insulin resistance in women with PCOS and obesity could provide further therapeutic options for early endometrial carcinoma.American Journal of Cancer Research 01/2014; 4(1):73-79. · 3.97 Impact Factor
- Gynäkologische Endokrinologie 02/2013; 11(1). DOI:10.1007/s10304-012-0526-2