Polycystic ovary syndrome and endometrial cancer risk: results from a nationwide cohort study

C L B Frandsen; M Gottschau; B Nøhr; J H Viuff; T Maltesen; S K Kjær; A Jensen; P F Svendsen

doi:10.1093/aje/kwae061

Polycystic ovary syndrome and endometrial cancer risk: results from a nationwide cohort study

Am J Epidemiol. 2024 May 16:kwae061. doi: 10.1093/aje/kwae061. Online ahead of print.

Authors

C L B Frandsen^{1

2}, M Gottschau¹, B Nøhr², J H Viuff³, T Maltesen⁴, S K Kjær^{1

5}, A Jensen¹, P F Svendsen²

Affiliations

¹ Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark.
² Department of Obstetrics and Gynecology, University Hospital of Herlev and Gentofte, Copenhagen, Denmark.
³ Diet, Cancer and Health, Danish Cancer Institute, Copenhagen, Denmark.
⁴ Statistics and Data Analysis, Danish Cancer Institute, Copenhagen, Denmark.
⁵ Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

PMID: 38751314
DOI: 10.1093/aje/kwae061

Abstract

Most previous studies have found an elevated risk of endometrial cancer among women with polycystic ovary syndrome (PCOS). However, these have highly varying methods for ascertainment of PCOS diagnoses and have limitations such as few exposed women and short follow-up. In this cohort study, we investigated the association between PCOS and endometrial cancer among women born in Denmark between January 1, 1940, and December 31, 1993 (N=1,719,121). Data in this study, including PCOS and endometrial cancer diagnoses and covariates, were derived from nationwide registers. We used cox proportional hazard regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 7862 endometrial cancer cases were identified during 23.7 years of follow-up (inter quartile range 37.7-61.9). We found an increased risk of endometrial cancer among women with PCOS compared with women without PCOS (HR: 3.02, 95% CI; 2.03-4.49). The risk was increased for premenopausal women (HR5.82, 95% CI: 3.64-9.30) whereas no marked association was seen for postmenopausal women. However, for postmenopausal women, results were limited by few cases and young age at end of follow-up. Mounting evidence of an increased risk for endometrial cancer among women with PCOS reinforces the need for prevention and early detection.

Keywords: PCOS; cohort study; endometrial cancer; menopause; population-based.

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