BACKGROUND: Although studies have found elevated risks of certain cancers linked to infertility, the underlying reasons remain unclear. METHODS: In a retrospective cohort study of 12,193 U.S. women evaluated for infertility between 1965 and 1988, 581 cases of cancer were identified through 1999. We used standardized incidence ratios (SIRs) to compare cancer risk with the general population. Analyses within the cohort estimated rate ratios (RRs) associated with infertility after adjusting for other risk predictors. RESULTS: Infertility patients demonstrated a higher cancer risk than the general population (SIR = 1.23; 95% confidence interval [CI] = 1.1-1.3), with nulligravid (primary infertility) patients at even higher risk (1.43; 1.3-1.6). Particularly elevated risks among primary infertility patients were observed for cancers of the uterus (1.93) and ovaries (2.73). Analyses within the cohort revealed increased RRs of colon, ovarian, and thyroid cancers, and of melanomas associated with endometriosis. Melanomas were linked with anovulatory problems, whereas uterine cancers predominated among patients with tubal disorders. When primary infertility patients with specific causes of infertility were compared with unaffected patients who had secondary infertility, endometriosis was linked with distinctive excesses of cancers of the colon (RR = 2.40; 95% CI = 0.7-8.4), ovaries (2.88; 1.2-7.1), and thyroid (4.65; 0.8-25.6) cancers, as well as melanomas (2.32; 0.8-6.7). Primary infertility due to anovulation particularly predisposed to uterine cancer (2.42; 1.0-5.8), and tubal disorders to ovarian cancer (1.61; 0.7-3.8). Primary infertility associated with male-factor problems was associated with unexpected increases in colon (2.85; 0.9-9.5) and uterine (3.15; 1.0-9.5) cancers. CONCLUSIONS: The effects of infertility may extend beyond gynecologic cancers. Thyroid cancers and melanomas deserve specific attention, particularly with respect to endometriosis.
BACKGROUND: Although studies have found elevated risks of certain cancers linked to infertility, the underlying reasons remain unclear. METHODS: In a retrospective cohort study of 12,193 U.S. women evaluated for infertility between 1965 and 1988, 581 cases of cancer were identified through 1999. We used standardized incidence ratios (SIRs) to compare cancer risk with the general population. Analyses within the cohort estimated rate ratios (RRs) associated with infertility after adjusting for other risk predictors. RESULTS:Infertilitypatients demonstrated a higher cancer risk than the general population (SIR = 1.23; 95% confidence interval [CI] = 1.1-1.3), with nulligravid (primary infertility) patients at even higher risk (1.43; 1.3-1.6). Particularly elevated risks among primary infertilitypatients were observed for cancers of the uterus (1.93) and ovaries (2.73). Analyses within the cohort revealed increased RRs of colon, ovarian, and thyroid cancers, and of melanomas associated with endometriosis. Melanomas were linked with anovulatory problems, whereas uterine cancers predominated among patients with tubal disorders. When primary infertilitypatients with specific causes of infertility were compared with unaffected patients who had secondary infertility, endometriosis was linked with distinctive excesses of cancers of the colon (RR = 2.40; 95% CI = 0.7-8.4), ovaries (2.88; 1.2-7.1), and thyroid (4.65; 0.8-25.6) cancers, as well as melanomas (2.32; 0.8-6.7). Primary infertility due to anovulation particularly predisposed to uterine cancer (2.42; 1.0-5.8), and tubal disorders to ovarian cancer (1.61; 0.7-3.8). Primary infertility associated with male-factor problems was associated with unexpected increases in colon (2.85; 0.9-9.5) and uterine (3.15; 1.0-9.5) cancers. CONCLUSIONS: The effects of infertility may extend beyond gynecologic cancers. Thyroid cancers and melanomas deserve specific attention, particularly with respect to endometriosis.
Authors: Barbara Luke; Morton B Brown; Logan G Spector; Stacey A Missmer; Richard E Leach; Melanie Williams; Lori Koch; Yolanda Smith; Judy E Stern; G David Ball; Maria J Schymura Journal: Fertil Steril Date: 2015-08-10 Impact factor: 7.329
Authors: Britton Trabert; Tim Waterboer; Annika Idahl; Nicole Brenner; Louise A Brinton; Julia Butt; Sally B Coburn; Patricia Hartge; Katrin Hufnagel; Federica Inturrisi; Jolanta Lissowska; Alexander Mentzer; Beata Peplonska; Mark E Sherman; Gillian S Wills; Sarah C Woodhall; Michael Pawlita; Nicolas Wentzensen Journal: J Natl Cancer Inst Date: 2019-02-01 Impact factor: 13.506
Authors: Ruth M Pfeiffer; Aya Mitani; Ola Landgren; Anders Ekbom; Sigurdur Y Kristinsson; Magnus Björkholm; Robert J Biggar; Louise A Brinton Journal: Cancer Causes Control Date: 2009-06-30 Impact factor: 2.506
Authors: Melissa M Smarr; Katherine J Sapra; Alison Gemmill; Linda G Kahn; Lauren A Wise; Courtney D Lynch; Pam Factor-Litvak; Sunni L Mumford; Niels E Skakkebaek; Rémy Slama; Danelle T Lobdell; Joseph B Stanford; Tina Kold Jensen; Elizabeth Heger Boyle; Michael L Eisenberg; Paul J Turek; Rajeshwari Sundaram; Marie E Thoma; Germaine M Buck Louis Journal: Hum Reprod Date: 2017-03-01 Impact factor: 6.918
Authors: Marina Kvaskoff; Fan Mu; Kathryn L Terry; Holly R Harris; Elizabeth M Poole; Leslie Farland; Stacey A Missmer Journal: Hum Reprod Update Date: 2015-03-11 Impact factor: 15.610
Authors: Julie Anne L Gemmill; Pamela Stratton; Sean D Cleary; Mary Lou Ballweg; Ninet Sinaii Journal: Fertil Steril Date: 2009-11-27 Impact factor: 7.329