Cited by 31Ovarian function and disordersCancer Risks and FactorsOvarian cancer diagnosis and treatment

Risk of endometrial, ovarian, and breast cancers in women with polycystic ovary syndrome: A systematic review and meta-analysis

Open access
Amiri, Mina, Bidhendi-Yarandi, Razieh, Fallahzadeh, Aida, Marzban, Zahra, Ramezani Tehrani, Fahimeh·2022·International Journal of Reproductive BioMedicine (IJRM)

Abstract

Background: Although several studies have evaluated the risk of gynecological cancers in women with polycystic ovary syndrome (PCOS), there are controversies regarding it. Objective: This study aimed to investigate the association of PCOS with endometrial, ovarian, and breast cancers. Materials and Methods: PubMed, Scopus, Web of Science, and Google Scholar databases based on MESH terms using the combination of the appropriate keywords were searched to retrieve observational studies on endometrial, ovarian, and breast cancers in PCOS women, published from inception to April 2020. This meta-analysis was performed to determine the pooled odds ratio (OR) of these cancers in women with PCOS. Publication bias was assessed by using Begg’s test. Results: Of 1347 records retrieved by searching the databases, a total of 14 articles were included in the study. Overall, the pooled OR of the composite outcome, including endometrial, ovarian, and breast cancers in women with PCOS was higher than that of women with no PCOS (pooled OR: 1.4, 95% CI: 1.0-1.9). The pooled OR of endometrial (pooled OR: 2.2, 95% CI: 1.03-4.7) and ovarian (pooled OR: 1.3, 95% CI: 1.0-1.8) cancers in women with PCOS was higher than the control group, whereas the pooled OR of breast cancer was not significantly higher than that of the control group. Conclusion: This meta-analysis indicated an increased risk of endometrial and ovarian cancers in women with PCOS. Key words: Polycystic ovary syndrome, Endometrial cancer, Ovarian cancer, Breast cancer.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.18502/ijrm.v20i11.12357

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The prevalence of eating disorders in this PCOS cohort is relatively high compared to other population studies that report a 0.3%-2.45% prevalence in those with PCOS.

    “This prevalence of eating disorders is relatively high compared to that found in other population studies that report a 0.3%-2.45% prevalence in those with PCOS.31,126,129,130”

    From Increased Prevalence of Adverse Health Outcomes Across the Lifespan in Those Affected by Polycystic Ovary Syndrome: A Canadian Population Cohort (2024) · cites this paper as [126]

    The Results section reports cancer outcomes in women with PCOS, not eating-disorder prevalence. Searches of our copy for eating disorders and the claimed 0.3%–2.45% range found no passage addressing either, so this source does not verify the attributed comparison. (LLM, conf=0.77)

    Experimental — accuracy not yet measured
  • The 30% higher prevalence of mental health and psychiatric disorders in PCOS is consistent with previous population cohort studies.

    “Our data showed that mental health and psychiatric disorders had a 30% higher prevalence in those with PCOS, consistent with findings of previous population cohort studies.6,29,31,32,126,127”

    From Increased Prevalence of Adverse Health Outcomes Across the Lifespan in Those Affected by Polycystic Ovary Syndrome: A Canadian Population Cohort (2024) · cites this paper as [126]

    The Introduction and Results (page numbers unavailable) address PCOS and endometrial, ovarian, and breast cancers, including findings from cohort studies of cancer risk. A search of our copy for mental health, psychiatric disorders, and the claimed 30% higher prevalence found no passage addressing that comparison. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 59

  1. March WA Moore VM Willson KJ Phillips DIW Norman RJ Davies MJ The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria Hum Reprod 2010 25 544 551 19910321
  2. Azziz R Carmina E Dewailly D Diamanti-Kandarakis E Escobar-Morreale HF Futterweit W et al Positions statement: Criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: An androgen excess society guideline J Clin Endocrinol Metab 2006 91 4237 4245 16940456
  3. Ramezani Tehrani F Amiri M Behboudi-Gandevani S Bidhendi-Yarandi R Carmina E Cardiovascular events among reproductive and menopausal age women with polycystic ovary syndrome: A systematic review and meta-analysis Gynecol Endocrinol 2020 36 12 23 31385729
  4. Burghen GA Givens JR Kitabchi AE Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease J Clin Endocrinol Metab 1980 50 113 116 7350174
  5. Dunaif A Segal KR Futterweit W Dobrjansky A Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome Diabetes 1989 38 1165 1174 2670645
  6. Daniilidis A Dinas K Long term health consequences of polycystic ovarian syndrome: A review analysis Hippokratia 2009 13 90 92 19561777 PMC2683463
  7. Cheung LP Ma RC Lam PM Lok IH Haines CJ So WY et al Cardiovascular risks and metabolic syndrome in Hong Kong Chinese women with polycystic ovary syndrome Hum Reprod 2008 23 1431 1438 18359783
  8. Balen A Polycystic ovary syndrome and cancer Hum Reprod Update 2001 7 522 525 11727859
  9. Carmina E Lobo RA Polycystic ovary syndrome (PCOS): Arguably the most common endocrinopathy is associated with significant morbidity in women J Clin Endocrinol Metab 1999 84 1897 1899 10372683
  10. Gibson M Reproductive health and polycystic ovary syndrome Am J Med 1995 98 67 75 7825642
  11. Ding D-Ch Chen W Wang J-H Lin Sh-Z Association between polycystic ovarian syndrome and endometrial, ovarian, and breast cancer: A population-based cohort study in Taiwan Medicine 2018 97 e12608 30278576 PMC6181615
  12. Risch HA Hormonal etiology of epithelial ovarian cancer, with a hypothesis concerning the role of androgens and progesterone J Natl Cancer Inst 1998 90 1774 1786 9839517
  13. Schildkraut JM Schwingl PJ Bastos E Evanoff A Hughes C Epithelial ovarian cancer risk among women with polycystic ovary syndrome Obstet Gynecol 1996 88 554 559 8841217
  14. Chittenden BG Fullerton G Maheshwari A Bhattacharya S Polycystic ovary syndrome and the risk of gynaecological cancer: A systematic review Reprod Biomed Online 2009 19 398 405 19778486
  15. Shen Ch-Ch Yang AC Hung J-H Hu L-Y Tsai Sh-J A nationwide population-based retrospective cohort study of the risk of uterine, ovarian and breast cancer in women with polycystic ovary syndrome Oncologist 2015 20 45 49 25410097 PMC4294614
  16. Kim J Mersereau JE Khankari N Bradshaw PT McCullough LE Cleveland R et al Polycystic ovarian syndrome (PCOS), related symptoms/sequelae, and breast cancer risk in a population-based case-control study Cancer Causes Control 2016 27 403 414 26797454 PMC4981498
  17. Anderson KE Sellers TA Chen PL Rich SS Hong CP Folsom AR Association of Stein-Leventhal syndrome with the incidence of postmenopausal breast carcinoma in a large prospective study of women in Iowa Cancer 1997 79 494 499 9028359
  18. Harris HR Terry KL Polycystic ovary syndrome and risk of endometrial, ovarian, and breast cancer: A systematic review Fertil Res Pract 2016 2 14 28620541 PMC5424400
  19. Moher D Liberati A Tetzlaff J Altman DG Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement Int J Surg 2010 8 336 341 20171303
  20. Stang A Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses Eur J Epidemiol 2010 25 603 605 20652370
  21. Higgins JPT Altman DG Gotzsche PC Juni P Moher D Oxman AD et al The Cochrane Collaboration's tool for assessing risk of bias in randomised trials BMJ 2011 343 d5928 22008217 PMC3196245
  22. Begg CB Mazumdar M Operating characteristics of a rank correlation test for publication bias Biometrics 1994 50 1088 1101 7786990
  23. Duval S Tweedie R Trim and fill: A simple funnel‐plot-based method of testing and adjusting for publication bias in meta‐analysis Biometrics 2000 56 455 463 10877304
  24. Mavridis D Salanti G How to assess publication bias: Funnel plot, trim-and-fill method and selection models Evid Based Ment Health 2014 17 30 24477535 PMC13404685
  25. Wild S Pierpoint T Jacobs H McKeigue P Long-term consequences of polycystic ovary syndrome: Results of a 31 year follow-up study Hum Fertil 2000 3 101 105 11844363
  26. Harris HR Titus LJ Cramer DW Terry KL Long and irregular menstrual cycles, polycystic ovary syndrome, and ovarian cancer risk in a population-based case-control study Int J Cancer 2017 140 285 291 27667654 PMC5542050
  27. Fearnley EJ Marquart L Spurdle AB Weinstein P Webb PM Australian ovarian cancer study group and australian national endometrial cancer study group Polycystic ovary syndrome increases the risk of endometrial cancer in women aged less than 50 years: An Australian case-control study Cancer Causes Control 2010 21 2303 2308 20953904
  28. Olsen CM Green AC Nagle CM Jordan SJ Whiteman DC Bain CJ et al Epithelial ovarian cancer: Testing the 'androgens hypothesis' Endocr Relat Cancer 2008 15 1061 1068 18772244
  29. Escobedo LG Lee NC Peterson HB Wingo PA Infertility-associated endometrial cancer risk may be limited to specific subgroups of infertile women Obstet Gynecol 1991 77 124 128 1984211
  30. Talamini R Franceschi S Favero A Negri E Parazzini F La Vecchia C Selected medical conditions and risk of breast cancer Br J Cancer 1997 75 1699 1703 9184190 PMC2223528
  31. Bodmer M Becker C Meier C Jick SS Meier CR Use of metformin and the risk of ovarian cancer: A case-control analysis Gynecol Oncol 2011 123 200 204 21802715
  32. Zucchetto A Serraino D Polesel J Negri E De Paoli A Dal Maso L et al Hormone-related factors and gynecological conditions in relation to endometrial cancer risk Eur J Cancer Prev 2009 18 316 321 19554665
  33. Lopes IMRS Baracat MCP Simoes Mde J Simoes RS Baracat EC Soares Jr JM Endometrium in women with polycystic ovary syndrome during the window of implantation Rev Assoc Med Bras 2011 57 702 709 22249553
  34. Schindler AE Progestogen deficiency and endometrial cancer risk Maturitas 2009 62 334 337 19231117
  35. Savaris RF Groll JM Young SL DeMayo FJ Jeong JW Hamilton AE et al Progesterone resistance in PCOS endometrium: A microarray analysis in clomiphene citrate-treated and artificial menstrual cycles J Clin Endocrinol Metab 2011 96 1737 1746 21411543 PMC3100753
  36. Nagmani M Hannigan EV Dillard JR EA Dinh TV Ovarian steroid secretion in postmenopausal women with and without endometrial cancer J Clin Endocrinol Metab 1986 62 508 512 3944235
  37. Apparao KBC Lovely LP Gui Y Lininger RA Lessey BA Elevated endometrial androgen receptor expression in women with polycystic ovarian syndrome Biol Reprod 2002 66 297 304 11804942
  38. Goodarzi MO Dumesic DA Chazenbalk G Azziz R Polycystic ovary syndrome: Etiology, pathogenesis and diagnosis Nat Rev Endocrinol 2011 7 219 231 21263450
  39. Konishi I Koshiyama M Mandai M Kuroda H Yamamoto S Nanbu K et al Increased expression of LH/hCG receptors in endometrial hyperplasia and carcinoma in anovulatory women Gynecol Oncol 1997 65 273 280 9159337
  40. Moran LJ Misso ML Wild RA Norman RJ Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: A systematic review and meta-analysis Hum Reprod Update 2010 16 347 363 20159883
  41. Saed L Varse F Baradaran HR Moradi Y Khateri S Friberg E et al The effect of diabetes on the risk of endometrial cancer: An updated a systematic review and meta-analysis BMC Cancer 2019 19 527 31151429 PMC6544993
  42. Haoula Z Salman M Atiomo W Evaluating the association between endometrial cancer and polycystic ovary syndrome Hum Reprod 2012 27 1327 1331 22367984
  43. Barry JA Azizia MM Hardiman PJ Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: A systematic review and meta-analysis Hum Reprod Update 2014 20 748 758 24688118 PMC4326303
  44. Helzlsouer KJ Alberg AJ Gordon GB Longcope C Bush TL Hoffman SC et al Serum gonadotropins and steroid hormones and the development of ovarian cancer JAMA 1995 274 1926 1930 8568986
  45. Schock H Surcel H-M Zeleniuch-Jacquotte A Grankvist K Lakso H-A Fortner RT et al Early pregnancy sex steroids and maternal risk of epithelial ovarian cancer Endocr Relat Cancer 2014 21 831 844 25270324 PMC4282682
  46. Butler M Ricciardelli C Tilley W Hickey T Androgen receptor protein levels are significantly reduced in serous ovarian carcinomas compared with benign or borderline disease but are not altered by cancer stage or metastatic progression Horm Cancer 2013 4 154 164 23443946 PMC10358082
  47. Lee J-Y Jeon I Kim JW Song Y-S Yoon JM Park SM Diabetes mellitus and ovarian cancer risk: A systematic review and meta-analysis of observational studies Int J Gynecol Cancer 2013 23 402 412 23354371
  48. Terry KL Willett WC Rich-Edwards JW Michels KB A prospective study of infertility due to ovulatory disorders, ovulation induction, and incidence of breast cancer Arch Intern Med 2006 166 2484 2489 17159014
  49. Picon-Ruiz M Morata-Tarifa C Valle-Goffin JJ Friedman ER Slingerland JM Obesity and adverse breast cancer risk and outcome: Mechanistic insights and strategies for intervention CA Cancer J Clin 2017 67 378 397 28763097 PMC5591063
  50. Meyer JS Cell proliferation in normal human breast ducts, fibroadenomas, and other ductal hyperplasias measured by nuclear labeling with tritiated thymidine Effects of menstrual phase, age, and oral contraceptive hormones Hum Pathol 1977 8 67 81 844855
  51. Gunter MJ Hoover DR Yu H Wassertheil-Smoller S Rohan TE Manson JE et al Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women J Natl Cancer Inst 2009 101 48 60 19116382 PMC2639294
  52. Secreto G Girombelli A Krogh V Androgen excess in breast cancer development: Implications for prevention and treatment. Endocr Relat Cancer 2019; 26: R81-R94 30403656
  53. Carvalho MJ Subtil S Rodrigues A Oliveira J Figueiredo-Dias M Controversial association between polycystic ovary syndrome and breast cancer Eur J Obstet Gynecol Reprod Biol 2019 243 125 132 31693949
  54. Sun Y-Sh Zhao Zh Yang Zh-N Xu F Lu H-J Zhu Zh-Y et al Risk factors and preventions of breast cancer Int J Biol Sci 2017 13 1387 1397 29209143 PMC5715522
  55. Shobeiri F Jenabi E The association between polycystic ovary syndrome and breast cancer: A meta-analysis Obstet Gynecol Sci 2016 59 367 372 27668199 PMC5028643
  56. Gammon MD Thompson WD Polycystic ovaries and the risk of breast cancer Am J Epidemiol 1991 134 818 824 1951277
  57. Pillay OC Te Fong LFW Crow JC Benjamin E Mould T Atiomo W et al The association between polycystic ovaries and endometrial cancer Hum Reprod 2005 21 924 929 16361289
  58. Baron JA Weiderpass E Newcomb PA Stampfer M Titus-Ernstoff L Egan KM et al Metabolic disorders and breast cancer risk (United States) Cancer Causes Control 2001 12 875 880 11808705
  59. Liu T Nie X Wu Z Zhang Y Feng G Cai S et al Can statistic adjustment of OR minimize the potential confounding bias for meta-analysis of case-control study? A secondary data analysis BMC Med Res Method 2017 17 179 PMC5747180 29284414

Cited by

Sorted by citations

Authors
Amiri, M., Bidhendi-Yarandi, R., Fallahzadeh, A., Marzban, Z., & Ramezani Tehrani, F.
Affiliations
  • Research Institute for Endocrine Sciences (IR)
  • University of Tehran (IR)
Venue
International Journal of Reproductive BioMedicine (IJRM)
Published
2022-12-12
Volume
20
Issue
11
Pages
893-914
ISSN
  • 1680-6433 (ISSN-L)
  • 2476-3772
  • 2476-4108
OpenAlex
W4312138259
Cited by
31
References
1
Citations by year
2026: 6 · 2025: 8 · 2024: 11 · 2023: 6
FWCI
1.01
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • International Journal of Reproductive BioMedicine (IJRM) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
Keywords
polycystic ovary syndrome, endometrial cancer, ovarian cancer, breast cancer, cancer risk, gynecologic cancer, hyperandrogenism

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review