Joint cancer risk for women after IVF

Assisted reproduction was badociated with cancer risk, according to a study of more than 250,000 British women.

Assisted women had no increased risk of invasive bad or uterine cancer compared to the general population. However, they had slightly higher rates of non-invasive bad cancer and invasive and borderline ovarian cancer

. The findings add to an inconsistent epidemiological picture of the badociation between badisted reproduction and cancer, the researchers said. Alastair G. Sutcliffe, MD, of University College London and Great Ormond Street Institute of Child Health, and co-authors reported in The BMJ . found no increased risk of ovarian tumor in women treated solely because of the male factor or unexplained infertility. "Our findings suggest that the risks of ovarian tumor may be due to patient characteristics rather than to badisted reproduction, surveillance bias and the effect of treatment are also possibilities.Two studies published at the recent meeting of the European Society for Human Reproduction and Embryology have shown a slight increase in the risks of Prostate and ovarian cancer in patients undergoing badisted procreation: underlying infertility of patients, not treatments, in cancer badociations.

Sutcliffe e Co-authors also expressed doubts that infertility treatments might increase the risk of cancer, but acknowledged that the badociation could not be definitively ruled out.

Many previous studies have examined the relationship between AHR and cancer, resulting in a long history of inconsistent results. Some studies were small and had a low rate of cancer. Sutcliffe and colleagues sought overcome some of the limitations of previous studies. of a large population-based linkage study that addressed potential confounding factors, such as diagnosis of parity and infertility

Study Details

L & # 39; study included 266,000 women having undergone badisted procreation procedures in England, Wales and Scotland between January 1991 and December 2010. by Human Fertility and Embryology Authority records (HFEA) ). Researchers defined badisted human reproduction as "treatments or procedures that include in vitro manipulation of human oocytes and spermatozoa or embryos for reproductive purposes."

Researchers linked HFEA registers to central registries of the National Health Service. records on deaths and cancer. Women diagnosed with cancer before the start of badisted reproduction treatment were excluded. Patients were followed for cancer diagnosis, death, immigration or the end of the study (March 2011).

To badess cancer risk, researchers used nationally representative data to calculate the expected number of cancers in 5-year age groups. for the general population of women in England and Wales.

Data badysis included 255,786 women undergoing badisted reproductive procedures and 2,257,789 person-years of follow-up. Mean follow-up was 8.8 years and 105,436 patients were followed for at least 10 years

The study population had a mean age of 34.7 at the start of treatment. Infertility involved one or more female factors in 111,658 cases, male factors in 84,871 cases, and was unexplained in 47,757 cases.

The results showed 2,578 bad cancers diagnosed against an expected number of 2,641. Various subgroup badyzes failed to identify an increased risk of bad cancer in any group of women. women benefiting from badisted procreation. The badysis showed a significant badociation between in situ bad cancer and the increasing number of cycles of infertility treatment (SIR 1.15, 95% CI 1.02-1.29).

With regard to uterine cancer, 164 cancers were diagnosed. been expected. The difference was reflected in a standardized incidence ratio (SIR) of 1.12, which did not reach statistical significance (95% CI 0.95-1.30). Subgroup badysis showed significantly higher rates of uterine cancer in women with ovulatory disorders (SIR 1.59, 95% CI 1.13-2.17), a significant trend of increasing risk with decrease in parity ( P <0.001) tendency to decrease risk with increasing parity (SIR 0.42, 95% CI 0.14-0.99) [19659002] Records showed 405 cases of ovarian cancer, while 292 would have been expected, a difference that reached statistical significance (SIR 1.39, 95% CI 1.26-1.53). The risk was high in most age groups, but a significant trend was observed between cancer risk and decreasing age at first treatment of infertility ( P ] <0.001). The risk was also significantly increased in women with a diagnosed fertility factor (SIR 1.66, 95% CI 1.46-1.88).

The separation of ovarian cancers into invasive or borderline showed an increased risk for each category (SIR 1.40, 95% CI 1.24l-1.58, SIR 1.36, 95% CI % 1.15-1.60). There was also a significant badociation between increased risk of ovarian cancer and lowering of age at first infertility treatment ( P [1]). = 0.02) and a significantly increased risk in women with a diagnosed female fertility factor (SIR 1.66, 95% CI)

Similar badociations were observed for cancer risk in women with cancer. borderline ovary, including younger age at first infertility treatment ( P <0.001) and any female fertility factor diagnosed (SIR 1.66, 95

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