Cancer Incidence in a Cohort of Infertile Woman

TLDR

Treatment with ovulation‑inducing drugs does not appear to increase ovarian cancer risk, though its role cannot be fully excluded. In a cohort of 2,496 infertile Israeli women, overall cancer incidence was 1.2 times the expected (143 observed vs 116.1 expected), with markedly elevated endometrial cancer risk (SIR 4.85, 95 % CI 3.0–7.4) and modest rises in ovarian (SIR 1.6) and breast (SIR 1.3) cancers; the endometrial excess was strongest among women with normal estrogen but progesterone deficiency (SIR 9.4). Am J Epidemiol 1998;147:1038–42.

Abstract

Among 2,496 infertile Israeli women treated between 1964 and 1974, 143 cancer cases were observed as compared with 116.1 expected (standardized incidence ratio (SIR) = 1.2,95% confidence interval (Cl) 1.0–1.5) through 1991. Site-specific analysis revealed 12 ovarian cancers versus 7.2 expected (SIR = 1.6, 95% Cl 0.8–2.9), 21 endometrial cancers versus 4.3 expected (SIR = 4.85, 95% Cl 3.0–7.4), and 59 breast cancers versus 46.6 expected (SIR = 1.3,95% Cl 0.96–1.6). Sensitivity analysis revealed that confounding was unlikely to explain the raised risk of endometrial cancer, but nulliparity might explain the increased risk of ovarian cancer. The excess of endometrial cancer was prominent among patients with normal estrogen production but progesterone deficiency (SIR = 9.4,95% Cl 5.0–16.0). The risk for ovarian cancer was similar among the total groups of treated and untreated patients (SIR = 1.7 vs. 1.6). The standardized incidence ratio for endometrial cancer was higher among the treated group than the untreated group, although not significantly. Treatment with ovulation-inducing drugs does not appear to increase the risk for ovarian cancer, but its role cannot be completely excluded. Am J Epidemiol 1998;147:1038–42.