A prospective cohort study of infertility and cancer incidence

To investigate the association between infertility and the incidence of invasive cancer. Prospective cohort study (1989-2015). Not applicable. A total of 103,080 women aged 25-42 years in the Nurses' Health Study II who were cancer-free at baseline (1989). The infertility status (failure to con...

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Bibliographic Details
Published in:Fertility and sterility Vol. 120; no. 1; p. 134
Main Authors: Wang, Siwen, Gaskins, Audrey J, Farland, Leslie V, Zhang, Dan, Birmann, Brenda M, Rich-Edwards, Janet W, Wang, Yi-Xin, Tamimi, Rulla M, Missmer, Stacey A, Chavarro, Jorge E
Format: Journal Article
Language:English
Published: United States 01.07.2023
Subjects:
Female
Humans
Incidence
Infertility, Female - diagnosis
Infertility, Female - epidemiology
Neoplasms - diagnosis
Neoplasms - epidemiology
Obesity - diagnosis
Obesity - epidemiology
Proportional Hazards Models
Prospective Studies
Risk Factors
endometrial cancer
cancer
ovarian cancer
Infertility
postmenopausal breast cancer
ISSN:1556-5653, 1556-5653
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Summary:To investigate the association between infertility and the incidence of invasive cancer. Prospective cohort study (1989-2015). Not applicable. A total of 103,080 women aged 25-42 years in the Nurses' Health Study II who were cancer-free at baseline (1989). The infertility status (failure to conceive after 1 year of regular, unprotected sex) and causes of infertility were self-reported at baseline and biennial follow-up questionnaires. Cancer diagnosis was confirmed through medical record review and classified as obesity-related (colorectal, gallbladder, kidney, multiple myeloma, thyroid, pancreatic, esophageal, gastric, liver, endometrial, ovarian, and postmenopausal breast) or non-obesity-related (all other cancers). We fit the Cox proportional-hazards models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the association between infertility and cancer incidence. During 2,149,385 person-years of follow-up, 26,208 women reported a history of infertility, and we documented 6,925 incident invasive cancer cases. After adjusting for body mass index and other risk factors, women who reported infertility had a higher risk of developing cancer than gravid women without a history of infertility (HR, 1.07; 95% CI, 1.02-1.13). This association was stronger among obesity-related cancers (HR, 1.13; 95% CI, 1.05-1.22; vs. non-obesity-related cancers, HR, 0.98; 95% CI, 0.91-1.06) and, in particular, obesity-related reproductive cancers (postmenopausal breast, endometrial, and ovarian cancers; HR, 1.17; 95% CI, 1.06-1.29) and was stronger among women who first reported infertility earlier in life (≤25 years, HR, 1.19; 95% CI, 1.07-1.33; 26-30 years, HR, 1.11; 95% CI, 0.99-1.25; >30 years, HR, 1.07; 95% CI, 0.94-1.22; P trend < .001). A history of infertility may be associated with the risk of developing obesity-related reproductive cancers; further study is needed to elucidate the underlying mechanisms.
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ISSN:1556-5653
1556-5653
DOI:10.1016/j.fertnstert.2023.02.028