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• Posted June 27, 2023

Women With PCOS Face Twice the Odds for Ovarian Cancer After Menopause

The risk for ovarian cancer among women with polycystic ovary syndrome (PCOS) doubles after they go through menopause, new research discovers.

“Our results and those from previous studies should be taken into account when revising guidelines on how to manage the health of women with PCOS in the long term,” said lead author Dr. Clarissa Frandsen, of the Danish Cancer Society Research Center in Copenhagen.

“Unfortunately, there is no effective screening for early detection of ovarian cancer. Both patients and clinicians will benefit from improved knowledge of the potential long-term health risks associated with PCOS,” she added.

While ovarian cancer is not as prevalent as breast cancer, it is three times more deadly. This research by the Danish Cancer Research Center and Herlev Hospital in Denmark focused on epithelial ovarian cancer, which starts on the surface of the ovary and accounts for about 90% of ovarian tumors.

The study included all 1.7 million women born in Denmark from January 1940 through December 1993, except for those who emigrated, died, were diagnosed with cancer or had surgery to remove their ovaries and fallopian tubes before the start of the study.

Additional analysis was done on women who had reached the age of 51, which is the average age in Denmark for menopause.

The study found that 6,490 women were diagnosed with epithelial ovarian cancer and 2,990 with borderline ovarian tumors during a median follow-up time of 26 years.

The researchers discovered that the risk of developing ovarian cancer was significantly greater among postmenopausal women compared to those without PCOS.

In addition, the risk was more than double for a type of ovarian tumor known as serous borderline among PCOS patients. While these abnormal cells are not classified as cancer, they also are not completely benign. Studies show they can lead to ovarian cancer later on. PCOS affects about 10% of women of childbearing age.

The findings were presented Monday at the European Society of Human Reproduction and Embryology (ESHRE) annual meeting, in Copenhagen, and simultaneously published online in the International Journal of Cancer.

“PCOS is a common but complex condition that represents a serious public health issue. It can affect a woman's chance of becoming pregnant and increase the odds of other diseases,” Dr. Maria Cristina Magli, laboratory director at The Italian Society for the Study of Reproductive Medicine in Bologna and immediate past chair of the ESHRE, said in a meeting news release.

“The odds of women with PCOS being diagnosed with ovarian cancer are very low. But the more that is known about the risks, the better doctors are able to monitor patients, especially those [in] postmenopause,” Magli added.

A study limitation is the low number of ovarian cancer cases despite the large study population.

The study authors said the data were "highly valid" but that diagnosis of PCOS is challenging, and they were unable "to account for changes in diagnostic practices over time."

The research also did not examine why postmenopausal women were more likely to develop ovarian cancer. Long-term exposure to potential cancer-causing factors could be a reason, including excess production of male sex hormones, Frandsen said.

More information

The Office on Women's Health has more on polycystic ovary syndrome.

SOURCE: European Society of Human Reproduction and Embryology, news release, June 26, 2023