Polycystic Ovarian Syndrome and the Risk of Ovarian, Endometrial, and Breast Cancer: A Systematic Review and Meta-Analysis.

BACKGROUND

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder in women that may be associated with an increased risk of various cancers. This meta-analysis aims to evaluate the relationship between PCOS and the risk of breast, ovarian, and endometrial cancers.

METHODS

We performed a comprehensive search of databases, including PubMed (Medline), Scopus, Web of Science, and Embase (Elsevier), covering the period from 1983 to November 2023. The review included cohort studies (both retrospective and prospective) and case-control studies. Study quality was assessed using the Newcastle-Ottawa Scale (NOS) for nonrandomized studies. Data analysis was conducted with Stata 17.

RESULTS

Our meta-analysis reviewed 13 studies on the association between Polycystic Ovary Syndrome (PCOS) and endometrial cancer, revealing a combined Relative Risk (RR) of 2.91 (95% CI: 2.29 - 3.70; I²: 61.97%; < 0.001), indicating a significantly increased risk of endometrial cancer among women with PCOS. For breast cancer, the pooled RR from the studies was 1.09 (95% CI: 0.97-1.22; I²: 55.81%; = 0.012), suggesting a modestly elevated risk. In the case of ovarian cancer, seven studies contributed to the analysis, resulting in a combined RR of 1.52 (95% CI: 1.17-1.97; I²: 49.22%; = 0.072). This finding indicates a moderate increase in risk for ovarian cancer in women with PCOS. These results collectively point to an elevated risk of endometrial, breast, and ovarian cancers in women with PCOS, although the magnitude of risk varies among different types of cancer.

CONCLUSION

This meta-analysis supports an elevated risk of endometrial, breast, and ovarian cancers in women with PCOS. These findings highlight the need for increased surveillance and preventive measures for women with PCOS to mitigate their cancer risk. Further research with larger sample sizes is needed to confirm these associations and explore underlying mechanisms.