PCOS Linked to Increased Risk of Endometrial Cancer, claims study

PCOS is a common endocrine disorder among women of reproductive age, characterized by irregular menstrual periods, excess androgen levels, and polycystic ovaries. Previous studies have suggested potential links between PCOS and various gynecologic cancers, but comprehensive data have been lacking. This study aimed to systematically investigate the relationship between PCOS and the risks of ovarian, endometrial, and cervical cancers using the extensive NIS database.

The study utilized the International Classification of Diseases (ICD-10) system to identify relevant codes from the NIS database for the period 2016 to 2019. Univariate and multivariable regression analyses were conducted to evaluate the association between PCOS and gynecologic cancers. These analyses were adjusted for several factors, including age, race, hospital region, hospital teaching status, income Zip score, smoking, alcohol use, and hormonal replacement therapy. Results were summarized using odds ratios (OR) with 95% confidence intervals (CI).

• The study analyzed data from 15,024,965 patients, with 56,183 diagnosed with PCOS and 14,968,782 without PCOS.

• Among patients diagnosed with gynecologic cancers (n = 91,599), there were 286 with PCOS and 91,313 without PCOS.

• PCOS was significantly associated with a higher risk of endometrial cancer (OR = 1.39, 95% CI [1.18–1.63], p < 0.0001).

• PCOS was associated with a lower risk of ovarian cancer (OR = 0.55, 95% CI [0.45–0.67], p < 0.0001) and cervical cancer (OR = 0.68, 95% CI [0.51–0.91], p = 0.009).

• After adjusting for confounding factors and applying the Bonferroni correction, PCOS remained significantly associated with a higher risk of endometrial cancer (OR = 3.90, 95% CI [4.32–4.59], p < 0.0001).

• There was no significant correlation between PCOS and the risk of ovarian cancer (OR = 1.09, 95% CI [0.89–1.34], p = 0.409) or cervical cancer (OR = 0.83, 95% CI [0.62–1.11], p = 0.218).

The findings from this extensive analysis indicate that patients with PCOS have a distinct risk profile for gynecologic cancers. Specifically, the significant association between PCOS and an increased risk of endometrial cancer highlights the need for heightened vigilance and possibly earlier screening for this patient group. The lack of significant association with ovarian and cervical cancers is also noteworthy, suggesting that the cancer risks associated with PCOS may be more specific to endometrial cancer.

This first-ever NIS analysis reveals that PCOS is associated with a higher risk of endometrial cancer, while no significant increased risk was found for ovarian or cervical cancers. These findings underscore the importance of tailored cancer screening and preventive strategies for patients with PCOS.

Reference:

Abu-Zaid, A., Baradwan, S., Alyafi, M., Al Baalharith, M., Alsehaimi, S. O., Alsabban, M., Alsharif, S. A., Alqarni, S. M. S., Albelwi, H., Jamjoom, M. Z., Saleh, S. A. K., Adly, H. M., Alomar, O., & Salem, H. (2024). Association between polycystic ovary syndrome and the risk of malignant gynecologic cancers (ovarian, endometrial, and cervical): A population-based study from the U.S.A. National Inpatient Sample 2016–2019. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 299, 283–288. https://doi.org/10.1016/j.ejogrb.2024.06.031