Human Reproduction, Vol. 16, No. 1, 196,
January 2001
© 2001 European Society of Human Reproduction and Embryology
Letters to the Editor |
Risk of endometrial cancer after use of fertility drugs
1 Istituto di Ricerche Farmacologiche Mario Negri, 20157 Milano and 2 Istituto di Statistica Medica e Biometria,Università degli Studi di Milano, 20133 Milano, Italy
Dear Sir,
Infertility and subsequent fertility treatments have been suggested as risk factors for female hormone-related cancers (Meirow and Schenker, 1996
). Several studies have investigated cancer incidence in infertile women who have been exposed to fertility drugs, suggesting a possible excess risk for ovarian cancer and controversial data for endometrial and breast cancer (Whittemore et al., 1992; Franceschi et al., 1994; Modan et al., 1998; Ricci et al., 1999). An Australian cohort study by Venn et al. (1999) found a significant excess of uterine cancer risk in infertile women not treated with fertility drugs. In a cohort study conducted in Israel, Modan et al. (1998) showed that the standardized incidence ratio for endometrial cancer was higher in the treated than in the untreated group, although the difference was not significant.
To provide further information on the association between endometrial cancer risk and fertility drugs, we analysed data from a case-control study conducted in northern Italy between 1983 and 1988, whose general design has already been described (Parazzini et al., 1991). Cases included 568 women aged <75 years with histologically confirmed endometrial cancer diagnosed within the year preceding the interview. Controls included 1787 women residing in the same area, who had been admitted for acute non-neoplastic, non-gynaecological conditions to the same network of hospitals.
Two (0.4%) cases and eight (0.4%) controls reported ever use of fertility drugs: the corresponding odds ratio, after allowance for age, education, parity, body mass index, oral contraceptive and hormonal replacement therapy use was 0.8 (95% confidence interval 0.2–4.3). The two cases reporting fertility drug use were treated >10 years before diagnosis of endometrial cancer. Consequently, our data do not provide meaningful information on the time-risk relation, nor on type of treatment.
Despite the low frequency of use, and hence the wide confidence interval, our findings indicate that fertility drugs are not a major risk factor for endometrial cancer in Italy.
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Notes
3 To whom correspondence should be addressed 
References
Franceschi, S., La Vecchia, C., Negri, E. et al. (1994) Fertility drugs and risk of epithelial ovarian cancer in Italy. Hum. Reprod., 9, 1673–1675
Meirow, D. and Schenker, J.G. (1996) The link between female infertility and cancer: epidemiology and possible etiologies. Hum. Reprod., Update, 2, 63–75
Modan, B., Ron, E., Lerner-Geva L. et al. (1998) Cancer incidence in a cohort of infertile women. Am. J. Epidemiol., 147, 1038–1042
Parazzini, F., La Vecchia, C., Negri, E. et al. (1991) Reproductive factors and risk of endometrial cancer. Am. J. Obstet. Gynecol., 164, 522–527
Ricci, E., Parazzini, F., Negri, E. et al. (1999) Fertility drugs and the risk of breast cancer. Hum. Reprod., 14, 1653–1655
Venn, A., Watson, L., Bruinsma, F. et al. (1999) Risk of cancer after use of fertility drugs with in-vitro fertilisation. Lancet, 354, 1586–1590[Web of Science][Medline]
Whittemore A., Harris R., Intyre J. and the Collaborative Ovarian Cancer Group. (1992) Characteristics relating to ovarian cancer risk: collaborative analysis of 12 case-control studies: II, invasive epithelial ovarian cancers in white women. Am. J. Epidemiol., 136, 1184–1203
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