American Journal of Epidemiology

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American Journal of Epidemiology Vol. 147, No. 11: 1038-1042
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Cancer Incidence in a Cohort of Infertile Woman

Baruch Modan^1,2, Elaine Ron³, Liat Lerner-Geva¹, Tzvia Blumstein¹, Joseph Menczer⁴, Jaron Rabinovici⁵, Gabriel Oelsner⁵, Laurence Freedman¹, Shlomo Mashiach⁵ and Bruno Lunenfeld⁶

¹Department of Clinical Epidemiology, Chaim Sheba Medical Center Tel Hashomer, Israel
²The Stanley Steyer Institute for Cancer Epidemiology and Research, Tel Aviv University Tel Aviv, Israel
³Radiation Epidemiology Branch, National Cancer Institute Bethesda, MD.
⁴Department of Gynecology, Edith Wolfson Medical Center Holon, Israel
⁵Department of Obstetrics and Gynecology, Chaim Sheba Medical Center Tel Hashomer, Israel
⁶Bar Ilan University Ramat Gan, Israel

Among 2,496 infertile Israeli women treated between 1964 and 1974, 143 cancer cases were observed as compared with 116.1 expected (standardized incidence ratio (SIR) = 1.2,95% confidence interval (Cl) 1.0–1.5) through 1991. Site-specific analysis revealed 12 ovarian cancers versus 7.2 expected (SIR = 1.6, 95% Cl 0.8–2.9), 21 endometrial cancers versus 4.3 expected (SIR = 4.85, 95% Cl 3.0–7.4), and 59 breast cancers versus 46.6 expected (SIR = 1.3,95% Cl 0.96–1.6). Sensitivity analysis revealed that confounding was unlikely to explain the raised risk of endometrial cancer, but nulliparity might explain the increased risk of ovarian cancer. The excess of endometrial cancer was prominent among patients with normal estrogen production but progesterone deficiency (SIR = 9.4,95% Cl 5.0–16.0). The risk for ovarian cancer was similar among the total groups of treated and untreated patients (SIR = 1.7 vs. 1.6). The standardized incidence ratio for endometrial cancer was higher among the treated group than the untreated group, although not significantly. Treatment with ovulation-inducing drugs does not appear to increase the risk for ovarian cancer, but its role cannot be completely excluded. Am J Epidemiol 1998;147:1038–42.

breast neoplasms; endometrial neoplasms; infertility; ovarian neoplasms; ovulation induction

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