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Tumor Discovery Cancer progression in PCOS

some of the common genetic mutations associated with included in the PRGs might drive PCOS patients toward
Type I endometrial carcinoma . These observations are cancer progression. Ethnically diverse and larger clinical
[96]
indicative of how patients with PCOS might be more prone trials along with molecular and bioinformatics approaches
to developing endometrial cancer. in an integrated manner are required to fully understand
Elevated androgen level is positively correlated with the the association of PCOS with cancer.
development of both PCOS and breast cancer . Xu et al. Acknowledgments
[81]
identified 53 potent key genes that contribute to the onset
of PCOS . Among these genes, HMGB2, PDGFRA, and None.
[81]
HSD17B4 are involved in the development of male sexual
characteristics. Xu et al. suggested that PCOS patients with Funding
downregulated HSD17B4 and upregulated PDGFRA may None.
have more risk of developing breast cancer .
[81]
Ovarian cancer and PCOS are strongly associated; Conflict of interest
however, the underlying molecular mechanism remains The authors declare that they have no competing interests.
largely unknown . Ovarian cancer can be divided into two
[97]
separate categories based on clinical behavior and molecular Author contributions
genetic abnormalities . Low-grade endometriosis, Conceptualization: Rubiat Afrin Ayon, Md. Ibrahim Khalil,
[98]
borderline serous tumors, low-grade serous carcinomas, and Md. Ashraful Hasan
mucinous, and clear cell carcinomas are examples of Type I
tumors, while examples of Type II ovarian cancer include Supervision: Md. Ibrahim Khalil and Md. Ashraful Hasan
undifferentiated tumors, carcinosarcomas, and high-grade Writing – original draft: Rubiat Afrin Ayon, Md. Azmain
serous carcinomas. High levels of genomic instability are Faike, Sumiya Zaman Ononna, Aminul Hassan,
present in Type II tumors. TP53 is a PCOS-related gene Shoumik Kundu, and Md. Ashraful Hasan
that is highly mutated in high-grade serous carcinoma .
[94]
However, ovarian cancer, as observed in a mouse model, Writing – review & editing: Rubiat Afrin Ayon, Farhana
was not triggered by TP53 mutation alone but, rather, was Akhter, Mohammad Mahfuz Ali Khan Shawan, Md.
cooperatively associated with PTEN loss . Mozammel Hossain, Md. Ibrahim Khalil, and Md.
[99]
Ashraful Hasan
5. Conclusion
PCOS is becoming a growing public health concern Ethics approval and consent to participate
globally because of its high incidence. Although there is Not applicable.
a growing body of evidence indicating the inclination of
PCOS patients to develop cancer due to shared metabolic Consent for publication
and endocrine abnormalities, the overall association Not applicable.
remains dubious. In our review, we extensively explored the
association of PCOS with various types of cancers, along Availability of data
with the potential risk factors and molecular mechanism.
We found that PCOS patients are more susceptible to Not applicable.
developing endometrial cancer than other reproductive References
cancers, but there is contradictory evidence linking PCOS
to either ovarian cancer or breast cancer. Due to the lack 1. Shermin S, Noor A, Jahan S, 2019, Polycystic ovary
of studies, it is difficult to draw a strong link between syndrome: A brief review with recent updates. Delta Med
PCOS and non-reproductive cancers. Disrupted hormonal Coll J, 7(2): 84–99.
balance, hyperinsulinemia, unchallenged high estrogen https://doi.org/10.3329/dmcj.v7i2.45567
level, chronic inflammation, sympathetic hyperactivity, 2. Hasan M, Sultana S, Sohan M, et al., 2022, Prevalence and
hyperandrogenism, and low progesterone level are all associated risk factors for mental health problems among
associated with normal PCOS progression and can also patients with polycystic ovary syndrome in Bangladesh:
contribute to oncogenesis and cancer progression in A nationwide cross-sectional study. PLoS One, 17(6): e0270102.
PCOS. PRGs have shown significant genomic alterations
in endometrial cancer, ovarian cancer, and breast cancer. https://10.1371/journal.pone.0270102
These PRGs include several cancer driver genes, thereby 3. Guzick DS, 2004, Polycystic ovary syndrome. Obstet
indicating that mutations in the cancer driver genes that are Gynecol, 103(1): 181–193.

Volume 2 Issue 1 (2023) 7 https://doi.org/10.36922/td.328