Shen Cheng-Che, Yang Albert C, Hung Jeng-Hsiu, Hu Li-Yu, Tsai Shih-Jen
Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan, Republic of China; Department of Information Management, National Chung-Cheng University, Chiayi, Taiwan, Republic of China; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China; School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China; Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan, Republic of China; School of Medicine, Tzu Chi University, Hualien, Taiwan, Republic of China; Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China.
Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan, Republic of China; Department of Information Management, National Chung-Cheng University, Chiayi, Taiwan, Republic of China; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China; School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China; Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan, Republic of China; School of Medicine, Tzu Chi University, Hualien, Taiwan, Republic of China; Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China
Oncologist. 2015 Jan;20(1):45-9. doi: 10.1634/theoncologist.2014-0311. Epub 2014 Nov 19.
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. We used a nationwide population-based retrospective cohort study to explore the relationship between PCOS and the subsequent development of gynecological cancers including uterine, breast, or ovarian cancer.
We identified subjects who were diagnosed with PCOS between January 1, 2000, and December 31, 2004, in the Taiwan National Health Insurance (NHI) Research Database. A comparison cohort was constructed for patients without known PCOS who were also matched according to age. All PCOS and control patients were observed until diagnosed with breast cancer, ovarian cancer, or uterine cancer or until death, withdrawal from the NHI system, or December 31, 2009.
The PCOS cohort consisted of 3,566 patients, and the comparison cohort consisted of 14,264 matched control patients without PCOS. The adjusted hazard ratio (HR) of uterine cancer and breast cancer in subjects with PCOS were higher (HR: 8.42 [95% confidence interval: 1.62-43.89] and HR: 1.99 [95% confidence interval: 1.05-3.77], respectively) than that of the controls during the follow-up. With the Monte Carlo method, only the mean adjusted HR of 1,000 comparisons for developing uterine cancer during the follow-up period was greater for the PCOS group than for the control groups (HR: 4.71, 95% confidence interval: 1.57-14.11).
PCOS might increase the risk of subsequent newly diagnosed uterine cancer. It is critical that further large-scale, well-designed studies be conducted to confirm the association between PCOS and gynecological cancer risk.
多囊卵巢综合征（PCOS）是育龄女性中最常见的内分泌疾病之一。我们采用一项基于全国人群的回顾性队列研究，以探讨PCOS与包括子宫癌、乳腺癌或卵巢癌在内的妇科癌症后续发生之间的关系。
我们在台湾国民健康保险（NHI）研究数据库中确定了2000年1月1日至2004年12月31日期间被诊断为PCOS的受试者。为无PCOS的患者构建了一个对照队列，这些患者也根据年龄进行了匹配。所有PCOS患者和对照患者均被观察至诊断为乳腺癌、卵巢癌或子宫癌，或直至死亡、退出NHI系统或2009年12月31日。
PCOS队列包括3566名患者，对照队列包括14264名匹配的无PCOS对照患者。在随访期间，PCOS患者患子宫癌和乳腺癌的调整后风险比（HR）高于对照组（分别为HR：8.42 [95%置信区间：1.62 - 43.89]和HR：1.99 [95%置信区间：1.05 - 3.77]）。采用蒙特卡罗方法，在随访期间，PCOS组发生子宫癌的1000次比较的平均调整后HR仅高于对照组（HR：4.71，95%置信区间：1.57 - 14.11）。
PCOS可能会增加后续新诊断子宫癌的风险。开展进一步的大规模、设计良好的研究以证实PCOS与妇科癌症风险之间的关联至关重要。
