Women with polycystic ovary syndrome at higher risk of pancreatic cancer: JAMA

It is known that only 11% of pancreatic cancer survive five years after diagnosis; given this, clinical surveillance is recommended for people at high risk. There are relatively few established risk factors for pancreatic cancer, knowledge of these can help detect other subgroups of individuals who may get help from increased education and clinical vigilance.

The researchers note that while millions of women have PCOS, pancreatic cancer remains a rare disease, with around 62,000 diagnoses of cases every year — about half of them in women.

PCOS is a common endocrine disorder that affects 1 in 10 women of childbearing age; it is linked with various carcinogenic processes and cancers. A 2019 Swedish register study showed that women with PCOS are at 3.4-fold higher risk of pancreatic cancer, but it had only five women with pancreatic cancer had PCOS, which was not adequate to draw a firm conclusion. Noah C. Peeri, Memorial Sloan Kettering Cancer Center, New York, New York, and colleagues sought to confirm this exploratory finding; by studying a much larger group of people. The analysis included 446 women with confirmed pancreatic adenocarcinoma and 209 controls.

The study led to the following findings:

• Women reporting a history of PCOS were more likely to have pancreatic cancer than controls, even after adjusting for age, race, ethnicity, body mass index, and estrogen use.
• The association between PCOS and pancreatic cancer was somewhat reduced after taking into account type 2 diabetes presence (OR=1.78) but was not driven by it.

"The results indicate that these women may have unknown metabolic disorders that contribute to the development of both conditions," the authors stated. "Given the low percentage of patients with pancreatic cancer who survive beyond five years after diagnosis, women with PCOS diagnosis should have more clinical vigilance and education regarding pancreatic cancer."

If PCOS is proven to be a marker for increased risk of pancreatic cancer, it could imply that women with PCOS may get help from increased surveillance for pancreatic cancer. Currently, there is no widespread surveillance for pancreatic cancer as studies are still being conducted to assess if there is a benefit. But some high-risk people are encouraged to be more vigilant in disease screening.

Reference:

Peeri NC, Landicino MV, Saldia CA, Kurtz RC, Rolston VS, Du M. Association Between Polycystic Ovary Syndrome and Risk of Pancreatic Cancer. JAMA Oncol. Published online October 06, 2022. doi:10.1001/jamaoncol.2022.4540