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Cancer risk among parous women following assisted reproductive technology.

作者信息

Reigstad M M, Larsen I K, Myklebust T Å, Robsahm T E, Oldereid N B, Omland A K, Vangen S, Brinton L A, Storeng R

机构信息

Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Rikshospitalet, Oslo, Norway Institute of Population-based Cancer Research, Cancer Registry of Norway, Oslo, Norway

Institute of Population-based Cancer Research, Cancer Registry of Norway, Oslo, Norway.

出版信息

Hum Reprod. 2015 Aug;30(8):1952-63. doi: 10.1093/humrep/dev124. Epub 2015 Jun 24.


DOI:10.1093/humrep/dev124
PMID:26113657
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4507330/
Abstract

STUDY QUESTION: Do women who give birth after assisted reproductive technology (ART) have an increased risk of cancer compared with women who give birth without ART? SUMMARY ANSWER: Without correction, the results indicate an increase in overall cancer risk, as well as a 50% increase in risk of CNS cancer for women giving birth after ART, however the results were not significant after correcting for multiple analyses. WHAT IS KNOWN ALREADY: Studies regarding the effects of hormonal treatments involved with ART on subsequent cancer risk have provided inconsistent results, and it has also been suggested that infertility itself could be a contributory factor. STUDY DESIGN, SIZE, DURATION: A population-based cohort consisting of all women registered in the Medical Birth Registry of Norway as having given birth between 1 January 1984 and 31 December 2010 was assembled (n = 812 986). Cancers were identified by linkage to the Cancer Registry of Norway. Study subjects were followed from start of first pregnancy during the observational period until the first cancer, death, emigration, or 31 December 2010. PARTICIPANTS/MATERIALS, SETTING, METHODS: Of the total study population (n = 806 248), 16 525 gave birth to a child following ART. Cox regression analysis computed hazard ratios (HR) and 95% confidence intervals (CI) comparing cancer risk between ART women and non-ART women; for overall cancer, and for cervical, ovarian, uterine, central nervous system (CNS), colorectal and thyroid cancers, and for malignant melanoma. MAIN RESULTS AND THE ROLE OF CHANCE: A total of 22 282 cohort members were diagnosed with cancer, of which 338 were ART women and 21 944 non-ART women. The results showed an elevated risk in one out of seven sites for ART women. The HR for cancer of the CNS was 1.50 (95% CI 1.03- 2.18), and among those specifically subjected to IVF (without ICSI) the HR was 1.83 (95% CI 1.22-2.73). Analysis of risk of overall cancer gave an HR of 1.16 (95% CI 1.04-1.29). Among those who had delivered only one child by the end of follow-up, the HR for ovarian cancer was 2.00 (95% CI 1.08-3.65), and for those nulliparous at entry the HR was 1.80 (95% CI 1.04-3.11). However, all findings became non-significant after correcting for multiple analyses. LIMITATIONS, REASONS FOR CAUTION: The results of elevated risk of overall cancer and CNS cancer lost significance when adjusting for multiple analyses, implying an important limitation of the study. The follow-up time was relatively short, especially for ART women. In addition, as the cohort was relatively young, there were few incident cancers, especially for some rarer cancer forms, such as uterine cancer. Risk assessments according to different causes of infertility could not be done. WIDER IMPLICATIONS OF THE FINDINGS: In light of the findings in the present study, further studies should be made on risk of CNS and ovarian cancer, and continued monitoring of all those treated with ART is encouraged. Our findings may only be generalizable to women who give birth after ART, and the risk for women who remain nulliparous after ART remains to be assessed. STUDY FUNDING/COMPETING INTEREST: The study was funded by the Norwegian National Advisory Unit on Women's Health. All authors claim no competing interests.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9931/4507330/345df2127606/dev12402.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9931/4507330/0cbeb2e13c51/dev12401.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9931/4507330/345df2127606/dev12402.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9931/4507330/0cbeb2e13c51/dev12401.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9931/4507330/345df2127606/dev12402.jpg

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[1]
Cancer risk among parous women following assisted reproductive technology.

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[2]
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[3]
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Cancer Causes Control. 2025-6

[4]
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Breast Cancer Res Treat. 2024-6

[5]
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Med Oncol. 2023-2-9

[6]
Risk of ovarian cancer in women who give birth after assisted reproductive technology (ART)-a registry-based Nordic cohort study with follow-up from first pregnancy.

Br J Cancer. 2023-3

[7]
Thyroid nodules and thyroid cancer in women with positive thyroid screening in pregnancy: a double-centric, retrospective, cohort study.

Eur Thyroid J. 2022-2-28

[8]
Hospitalizations up to 8 years following delivery in assisted reproductive technology-treated and subfertile women.

Fertil Steril. 2022-3

[9]
RUBIC (ReproUnion Biobank and Infertility Cohort): A binational clinical foundation to study risk factors, life course, and treatment of infertility and infertility-related morbidity.

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[10]
A Potential Pathogenic Link Between Cancer of Female Reproductive System and Infertile Women Treated With Assisted Reproduction Techniques.

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本文引用的文献

[1]
Melanoma risk after ovarian stimulation for in vitro fertilization.

Hum Reprod. 2015-3-4

[2]
Risk for borderline ovarian tumours after exposure to fertility drugs: results of a population-based cohort study.

Hum Reprod. 2015-1

[3]
Hormonal contraceptive use and risk of glioma among younger women: a nationwide case-control study.

Br J Clin Pharmacol. 2015-4

[4]
Risk of breast cancer following fertility treatment--a registry based cohort study of parous women in Norway.

Int J Cancer. 2015-3-1

[5]
Reproductive history and the risk of molecular breast cancer subtypes in a prospective study of Norwegian women.

Cancer Causes Control. 2014-7

[6]
Thyroid cancer after in vitro fertilization: a retrospective, non-consecutive case-series analysis.

Gynecol Endocrinol. 2014-8

[7]
Long-term relationship of ovulation-stimulating drugs to breast cancer risk.

Cancer Epidemiol Biomarkers Prev. 2014-4

[8]
Assisted reproductive technology surveillance -- United States, 2010.

MMWR Surveill Summ. 2013-12-6

[9]
Hormone replacement therapy and risk of glioma: a nationwide nested case-control study.

Cancer Epidemiol. 2013-10-16

[10]
Association between in-vitro fertilization, birth and melanoma.

Melanoma Res. 2013-12

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