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Cited by 721Ovarian cancer diagnosis and treatmentOvarian function and disordersCancer Risks and Factors

Ovarian Tumors in a Cohort of Infertile Women

Rossing, Mary Anne, Daling, Janet R., Weiss, Noel S., Moore, Donald E., Self, Steven G.·1994·New England Journal of Medicine
DOI 10.1056/nejm199409223311204
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Abstract

BACKGROUND: Case reports and the results of a recent case-control study have raised questions about the potential neoplastic effects of medications used as treatment for infertility. METHODS: We examined the risk of ovarian tumors in a cohort of 3837 women evaluated for infertility between 1974 and 1985 in Seattle. Computer linkage with a population-based tumor registry was used to identify women in whom tumors were diagnosed before January 1, 1992. Data on infertility testing and treatment were abstracted from the medical records of women who had ovarian cancer and those of a randomly selected comparison group. The risk of ovarian tumors associated with exposure to ovulation-inducing medications was assessed through an age-standardized comparison with the rate of ovarian tumors in the general population, and Cox regression analysis was used to compare the risk of cancer among women who received these medications with the risk among infertile women who did not receive them. RESULTS: There were 11 invasive or borderline malignant ovarian tumors, as compared with an expected number of 4.4 (standardized incidence ratio, 2.5; 95 percent confidence interval, 1.3 to 4.5). Nine of the women in whom ovarian tumors developed had taken clomiphene; the adjusted relative risk among these women, as compared with that among infertile women who had not taken this drug, was 2.3 (95 percent confidence interval, 0.5 to 11.4). Five of the nine women had taken the drug during 12 or more monthly cycles. This period of treatment was associated with an increased risk of ovarian tumors among both women with ovarian abnormalities and those without apparent abnormalities (relative risk, 11.1; 95 percent confidence interval, 1.5 to 82.3), whereas treatment with the drug for less than one year was not associated with an increased risk. CONCLUSIONS: Prolonged use of clomiphene may increase the risk of a borderline or invasive ovarian tumor.

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Crossref · 10.1056/nejm199409223311204

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Authors
Rossing, M. A., Daling, J. R., Weiss, N. S., Moore, D. E., & Self, S. G.
Affiliations
  • University of Washington (US)
  • Fred Hutch Cancer Center (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1994-09-22
Volume
331
Issue
12
Pages
771-776
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199409223311204
OpenAlex
W2315888143
Cited by
721
References
14
Citations by year
2026: 5 · 2025: 3 · 2024: 14 · 2023: 20 · 2022: 11 · 2021: 10 · 2020: 13 · 2019: 12 · 2018: 12 · 2017: 18 · 2016: 17 · 2015: 15 · 2014: 20 · 2013: 29 · 2012: 31
FWCI
31.19
Type
journal article
Language
en
Open access
closed
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (n01cn005230-022)
  • National Cancer Institute (R35 CA 39779, N01CN05230, R35CA039779)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
Keywords
ovarian neoplasms, ovarian cancer, infertility, clomiphene citrate, drug-induced cancer risk, borderline ovarian tumors, treatment duration, ovarian abnormalities
MeSH terms
Adult, Clomiphene, Female, Follow-Up Studies, Humans, Infertility, Female, Middle Aged, Ovarian Neoplasms, Regression Analysis, Risk, Washington, Cohort Studies, Confidence Intervals, Case-Control Studies

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