Page 17 - TD-2-1

Tumor Discovery Cancer progression in PCOS

areas of study [49,53] . Among the factors, nuclear factor-κB et al. observed that these patients had 4 times increased
(NF-κB) is a potential effector of inflammation induced by risk of endometrial cancer, with a standardized incidence
hyperandrogenism. The expression of NF-κB is enhanced ratio (SIR) of 3.9 (95% confidence index [CI] = 2.2 – 6.3)
through increased level of phosphorylation that induces [69] . Nearly one-third of these women were between the
ROS production and inflammatory responses [36,49,54] . ages of 15 and 24 at the time of their first admission or
visit for PCOS, and about 50% were between the ages of 25
3. Polycystic ovary syndrome and cancer and 34 . In another population-based, retrospective, and
[69]
PCOS is an intrinsic endocrine and metabolic condition cohort study, a higher mean adjusted hazard ratio (HR) of
[70]
that seriously affects menstrual and reproductive uterine cancer was found in PCOS patients . A report
functions, causing detrimental effects on a woman’s health by Haoula et al. concluded that endometrial cancer is
throughout her lifetime. Although PCOS has been linked 3 times more likely to develop in patients with PCOS in
[71]
to hyperandrogenism, genetic, and epigenetic factors, the comparison with women without it . A meta-analysis has
exact cause of PCOS remains unknown [55,56] . Between 6% reported increased risk of endometrial cancer in PCOS
and 20% of premenopausal women have PCOS, possibly patients, with an odds ratio (OR) of 2.79 at CI = 1.31 – 5.95
[61]
making it the most prevalent endocrine and metabolic (P < 0.008) . The risk estimate increased when women
[61]
condition among women of reproductive age [57-59] . The aged <54 were excluded from the study . A case–control
risk of cancer among PCOS-affected women has been a study by Fearnley et al. showed a link between PCOS and an
debatable topic over the years . There remains, however, increased risk of endometrial cancer in women under the
[8]
[72]
absence of adequate conclusive research linking PCOS age of 50 . Pillay et al. also observed a higher prevalence
[67]
to the risk of various cancers due to uncertainties in of PCOS in endometrial cancer patients aged below 50 .
its etiopathology, dubious diagnostic standards, and 3.1.2. Ovarian cancer
the complex endocrine and metabolic dysfunctions .
[60]
PCOS is conjectured to be linked to various types of Ovarian cancer is the seventh most common type of
[73]
reproductive cancers, including endometrial cancer, neoplasm in women worldwide . Around 239,000 new
ovarian cancer, breast cancer, uterine cancer, and others. cases and 152,000 fatalities worldwide are reported each
One of the primary clinical signs of PCOS, chronic year, with Eastern and Central Europe having the highest
[60]
oligo- or anovulation, induced by continuous estrogen incidence . It has been proposed that PCOS increases the
[74]
exposure without counteracting progesterone, was linked risk of ovarian cancer by increasing androgen exposure .
to endometrial cancer in initial reports of the relationship Cancer risk and infertility have been linked, albeit
between PCOS and cancer [61,62] . the debatable association with ovarian cancer. The most
common reasons of infertility in female are hormonal
3.1. Risk and underlying factors of developing conditions that interfere with ovulation, including PCOS.
reproductive cancer in polycystic ovary syndrome Ovarian cancer has been linked to a number of endocrine
3.1.1. Endometrial cancer and reproductive changes. As a result, nulliparity, early
menarche, and a later onset of menopause have all been
Endometrial cancer predominantly affects 2–3% of [75-78]
postmenopausal women and is the most prevalent female linked to an increased risk of ovarian cancer . Four
genital tract malignancy worldwide [63,64] . According to studies, studies have explicitly looked at the relationship between
. However, most these
PCOS and ovarian cancer
[61,69,70,79]
women with PCOS may have a higher chance of developing studies have presented mainly negative results although
endometrial cancer than those without the condition . one recent meta-analysis of three studies did imply an
[65]
Women with PCOS have multiple endometrial cancer risk elevated risk (OR = 1.4; 95% CI = 0.9 – 2.2) . According
[61]
factors and their risk for developing endometrial cancer to a Danish registry-based study, women with PCOS had a
may be higher . Prolonged and unchallenged exposure non-significantly higher risk of developing ovarian cancer
[66]
of estrogen to the endometrium of PCOS patients, low than the general Danish female population (SIR = 1.8; 95%
progesterone, obesity, hyperinsulinemia, insulin resistance, CI = 0.8 – 3.2); however, the study was constrained by its
IGF, diabetes, nulliparity, cyclin D1, and glutathione small sample size (10 ovarian cases) . No correlation
[69]
S-transferase constitute the clinical, metabolic, and molecular was found between PCOS and ovarian cancer in a recent
risk factors for endometrial cancer development [66-68] .
Taiwanese investigation with only 11 occurrences of the
Six studies have looked into the link between PCOS disease (HR = 1.0; 95% CI = 0.2 – 4.6) . Following a
[70]
and endometrial cancer without taking body mass index retrospective cohort study of women with PCOS, Brinton
(BMI) into consideration (Table 1). In a registry-based et al. found that patients with secondary infertility had a
cohort study of 12,070 women with PCOS, Gottschau higher risk of developing ovarian cancer than those with

Volume 2 Issue 1 (2023) 4 https://doi.org/10.36922/td.328