Reproductive Factors and the Risk of Endometrial Cancer

AbstractEndometrial cancer is the most common malignancy of women in developed countries, and its incidence is 10 times higher than in developing countries. Endometrial cancer is most common in the sixth and the seventh decades of life; thus, postmenopausal women have a higher risk of developing the disease compared with premenopausal women. The increased incidence and prevalence of endometrial cancer can be explained by the increase in life expectancy, increased caloric intake, increased obesity rates, and other changes in lifestyle and reproductive factors. Among the reproductive factors, the risk of endometrial cancer is positively correlated with a younger age at menarche and late age at menopause, infertility, null parity, age of the first child, and long-term use of unopposed estrogens for hormone replacement therapy. Protection against endometrial cancer has been detected with increase parity, the use of combined oral contraceptives, and increased age of women at last delivery. The relationship between endometrial cancer risk and miscarriage, abortion, ovulation induction drugs and in vitro fertilization is still controversial.

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Pregnancy Outcomes Using Assisted Reproductive Technology After Fertility-Preserving Therapy in Patients With Endometrial Adenocarcinoma or Atypical Complex Hyperplasia

International Journal of Gynecological Cancer ◽

10.1111/igc.0b013e31819960ba ◽

2009 ◽

Vol 19 (1) ◽

pp. 147-151 ◽

Cited By ~ 23

Author(s):

Aera R. Han ◽

Yong-Soon Kwon ◽

D. Y. Kim ◽

J. H. Kim ◽

Y. M. Kim ◽

...

Keyword(s):

Endometrial Cancer ◽

Assisted Reproductive Technology ◽

Intrauterine Insemination ◽

Medical Center ◽

Endometrial Adenocarcinoma ◽

Controlled Ovarian Hyperstimulation ◽

Reproductive Technology ◽

Vitro Fertilization ◽

Asan Medical

Objectives:To evaluate the outcomes of pregnancy in young women (<40 years old) with early endometrial cancer or atypical complex hyperplasia who were treated by conservative management followed by assisted reproductive technology (ART).Materials and Methods:Medical charts of 11 patients treated from January 1997 to October 2007 at Asan Medical Center were retrospectively reviewed. These patients had all been treated with progestin and serial dilatation and curettage as primary fertility-preserving therapies.Results:After pathological remission of disease, 10 patients tried to become pregnant by ART, 4 by in vitro fertilization and embryo transfer, and 6 by controlled ovarian hyperstimulation, with or without intrauterine insemination. Eight women had intrauterine pregnancies, and 6 patients had live births. Patients have been followed up for 9 to 51 months (mean, 21 months) after delivery, with no evidence of tumor recurrence.Conclusions:Fertility-preserving therapy followed by ART can be a good option in well-selected patients with early endometrial cancer who want to become pregnant.

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THE RISK OF DEVELOPING GYNECOLOGICAL CANCER IN WOMEN AFTER AN IN VITRO FERTILIZATION PROGRAM

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2021-23-9-7-13 ◽

2021 ◽

pp. 7-13

Author(s):

Allakhyarov D.Z. ◽

Petrov Yu.A. ◽

Palieva N.V.

Keyword(s):

Breast Cancer ◽

Ovarian Cancer ◽

Endometrial Cancer ◽

In Vitro Fertilization ◽

Gynecological Cancer ◽

The Body ◽

Fertilization Program ◽

Vitro Fertilization ◽

Increased Risk

This article presents reviews of literature sources on the issue of assessing the risk of developing gynecological cancer in women after an in vitro fertilization program. Infertility and infertile marriages have now become quite a big problem of modern medicine. Against the background of the unfavorable demographic situation in the Russian Federation, this problem is becoming quite urgent. The main way to solve this situation is assisted reproductive technologies, among which the most common is in vitro fertilization. The in vitro fertilization program is accompanied by a hormonal ovulation stimulation procedure to obtain a female germ cell capable of fertilization. Against the background of the active use of the in vitro fertilization procedure, many patients had concerns related to the risk of developing gynecological cancer after the IVF procedure, which is due to the use of hormonal drugs to stimulate the ovaries. Also of concern is the fact that certain types of cancer, including ovarian cancer, endometrial cancer and breast cancer, are hormone-dependent. In this regard, multiple large-scale studies were conducted, which showed that the risk of developing gynecological cancer is really increased in patients after the in vitro fertilization program. In particular, breast cancer in women after the in vitro fertilization program is more common by 10%, and in women without a history of pregnancy and over the age of 40, it is more common by 31%. The increased risk may be due to age-related vulnerability to the effects of hormones or higher doses of hormones during the IVF procedure. Ovarian cancer and endometrial cancer are also more common in patients after IVF. According to the research results, it is suggested that it is not the IVF procedure itself that causes the development of cancer, but excessive hormonal load of the body, which leads to the launch of carcinogenesis.

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New Beginnings

Experiments in Democracy ◽

10.7312/columbia/9780231179546.003.0002 ◽

2017 ◽

pp. 39-78

Author(s):

J. Benjamin Hurlbut

Keyword(s):

Human Subjects ◽

National Commission ◽

Vitro Fertilization ◽

Department Of Health ◽

Human In Vitro Fertilization ◽

First Child ◽

New Beginnings ◽

Protection Of Human Subjects

Chapter 1 examines the period from the mid-1960s to 1980. During this period, scientific advances made in human in vitro fertilization and embryo culture led to the birth of Louise Brown, the first child conceived through IVF, in 1978. The chapter examines the deliberations of two federal bioethics bodies: the National Commission for the protection of Human Subjects of Behavioral and Biomedical research, and the Ethics Advisory Board of the Department of Health, Education and Welfare.

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Randomized, controlled pilot trial of natural versus hormone replacement therapy cycles in frozen embryo replacement in vitro fertilization

Fertility and Sterility ◽

10.1016/j.fertnstert.2015.07.1131 ◽

2015 ◽

Vol 104 (4) ◽

pp. 915-920.e1 ◽

Cited By ~ 22

Author(s):

Ginny Mounce ◽

Enda McVeigh ◽

Karen Turner ◽

Tim J. Child

Keyword(s):

Hormone Replacement Therapy ◽

In Vitro Fertilization ◽

Replacement Therapy ◽

Hormone Replacement ◽

Pilot Trial ◽

Vitro Fertilization ◽

Randomized Controlled ◽

Embryo Replacement

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Glycaemic index, glycaemic load and risk of endometrial cancer: a prospective cohort study

Public Health Nutrition ◽

10.1079/phn2005741 ◽

2005 ◽

Vol 8 (7) ◽

pp. 912-919 ◽

Cited By ~ 35

Author(s):

Stephanie AN Silvera ◽

Thomas E Rohan ◽

Meera Jain ◽

Paul D Terry ◽

Geoffrey R Howe ◽

...

Keyword(s):

Endometrial Cancer ◽

Cohort Study ◽

Cancer Risk ◽

Hormone Replacement ◽

Premenopausal Women ◽

Glycaemic Index ◽

Obese Women ◽

Endometrial Cancer Risk ◽

Glycaemic Load

AbstractObjectiveHigh-glycaemic-load diets may increase endometrial cancer risk by increasing circulating insulin levels and, as a consequence, circulating oestrogen levels. Given the paucity of epidemiological data regarding the relationship between dietary glycaemic index and glycaemic load and endometrial cancer risk, we sought to examine these associations using data from a prospective cohort study.Design, setting and subjectsWe examined the association between dietary glycaemic load and endometrial cancer risk in a cohort of 49 613 Canadian women aged between 40 and 59 years at baseline who completed self-administered food-frequency questionnaires between 1982 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000.ResultsDuring a mean of 16.4 years of follow-up, we observed 426 incident cases of endometrial cancer. Hazard ratios for the highest versus the lowest quartile level of overall glycaemic index and glycaemic load were 1.47 (95% confidence interval (CI) = 0.90–2.41; P for trend = 0.14) and 1.36 (95% CI = 1.01–1.84; P for trend = 0.21), respectively. No association was observed between total carbohydrate or total sugar consumption and endometrial cancer risk. Among obese women (body mass index > 30 kg m−2) the hazard ratio for the highest versus the lowest quartile level of glycaemic load was 1.88 (95% CI = 1.08–3.29; P for trend = 0.54) and there was a 55% increased risk for the highest versus the lowest quartile level of glycaemic load among premenopausal women. There was also evidence to support a positive association between glycaemic load and endometrial cancer risk among postmenopausal women who had used hormone replacement therapy.ConclusionsOur data suggest that diets with high glycaemic index or high glycaemic load may be associated with endometrial cancer risk overall, and particularly among obese women, premenopausal women and postmenopausal women who use hormone replacement therapy.

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Can Aspirin Reduce the Risk of Endometrial Cancer?: A Systematic Review and Meta-analysis of Observational Studies

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000731 ◽

2016 ◽

Vol 26 (6) ◽

pp. 1111-1120 ◽

Cited By ~ 12

Author(s):

Dongyu Zhang ◽

Bei Bai ◽

Yuzhi Xi ◽

Yuqian Zhao

Keyword(s):

Endometrial Cancer ◽

Dose Response ◽

Subgroup Analysis ◽

Meta Analysis ◽

Hormone Replacement ◽

Premenopausal Women ◽

Type I ◽

Obese Women ◽

Case Control Studies ◽

Statistical Heterogeneity

AbstractCurrent evidences suggest that nonsteroidal anti-inflammatory drugs can reduce the risk of several types of cancer, including breast, prostate, and colorectal cancer. However, evidences regarding the chemopreventive effect of aspirin to endometrial cancer are inconsistent. Therefore, we aimed to further explore the association. We searched PubMed, EMBASE, Web of Science, and Scopus to identify potentially eligible studies. After title/abstract screening and full-text review, we identified 7 cohort studies and 6 case-control studies. Data extraction and quality assessment were performed independently, and a random-effects model was used for data synthesis. Subgroup analysis was conducted based on obesity, hormone replacement therapy use, and cancer subtype; sensitivity analysis was conducted by pooling risk ratios of the highest dosage or longest duration of use. Dose-response relationship was assessed by a 2-stage linear dose-response model. Statistical heterogeneity was assessed by theI2value and a χ2test for the Cochrane Q statistic. In overall meta-analysis, the pooled risk ratio was 0.93 (95% confidence interval, 0.88–0.99), and no substantial statistical heterogeneity was observed (I2= 0.0%,P= 0.550). In subgroup analysis, a negative association was observed for obese women and type I endometrial cancer. Higher dosage or frequency of aspirin use was significantly associated with a reduced risk, and long-term aspirin use was protective only for obese women. In conclusion, our study suggests that the use of aspirin can reduce the risk of endometrial cancer, particularly for obese women. However, the generalizability of our conclusion should be further studied for premenopausal women and type II endometrial cancer.

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