TY - JOUR
T1 - A prospective cohort study of infertility and cancer incidence
AU - Wang, Siwen
AU - Gaskins, Audrey J.
AU - Farland, Leslie V.
AU - Zhang, Dan
AU - Birmann, Brenda M.
AU - Rich-Edwards, Janet W.
AU - Wang, Yi Xin
AU - Tamimi, Rulla M.
AU - Missmer, Stacey A.
AU - Chavarro, Jorge E.
N1 - Funding Information:
S.W. has nothing to disclose. A.J.G. is partially supported by R01HD096033 from the National Institutes of Health for the submitted work, reports funding from the National Institutes of Health relating to infertility (R00ES026648, R01ES032446, and R21ES034130); is medical advisor to Doveras Fertility Inc., and has stock options in the company outside the submitted work. L.V.F. reports funding from the National Institutes of Health, Centers for Disease Control and Prevention, and Federal Emergency Management Agency and travel support from the Pacific Coast Reproductive Society outside the submitted work. D.Z. has nothing to disclose. B.M.B. reports funding from the National Institutes of Health/National Cancer Institute, Harvard TH Chan-NIEHS Center, and American Institute for Cancer Research and honoraria from Harvard University outside the submitted work. J.W.R.-E. reports funding from the US National Institutes of Health for the submitted work. Y.-X.W. has nothing to disclose. R.M.T. has nothing to disclose. S.A.M. reports funding from the US National Institutes of Health for the submitted work; funding from AbbVie, Department of Defense, and Marriot Family Foundations; honoraria from University British Columbia, WERF, and Huilun Shanghai; travel support from ESHRE 2020, Society for Reproductive Investigation – 69th Annual Scientific Meeting (2022), ESHRE 2022, FWGBD 2022, University of Michigan, Massachusetts Institute of Technology, and ASRM 2022; personal fees from the advisory board of AbbVie and Roche, Frontiers in Reproductive Health Field Chief Editor, and Abbott Roundtable participation; and leadership roles with the SWHR, WERF, WES, ASRM, and ESHRE outside the submitted work. J.E.C. reports funding from the National Institutes of Health and Food and Drug Administration; royalties from Harvard University; honoraria from Johns Hopkins University School of Medicine, National Institutes of Health, Northwestern University Feinberg School of Medicine, Carolinas Medical Center, American Society for Reproductive Medicine, British Dietetic Association, Pacific Coast Reproductive Society, Tufts University, and Zheijang University School of Medicine (China); and travel support from Johns Hopkins University School of Medicine, Pacific Coast Reproductive Society, European Society of Human Reproduction and Embryology, Health Sciences University School of Medicine (Colombia), Institut Hospital del Mar d’Investigacions Mediques (Spain), Japanese Society for Reproductive Medicine (Japan), Zheijang University School of Medicine (China), Lund University Faculty of Medicine (Sweden), and Medical University of Vienna (Austria) outside the submitted work.
Funding Information:
Supported by grants U01 CA176726, U01 HL145386, and R01 HD096033 from the National Institutes of Health. S.W. has nothing to disclose. A.J.G. is partially supported by R01HD096033 from the National Institutes of Health for the submitted work, reports funding from the National Institutes of Health relating to infertility (R00ES026648, R01ES032446, and R21ES034130); is medical advisor to Doveras Fertility Inc., and has stock options in the company outside the submitted work. L.V.F. reports funding from the National Institutes of Health, Centers for Disease Control and Prevention, and Federal Emergency Management Agency and travel support from the Pacific Coast Reproductive Society outside the submitted work. D.Z. has nothing to disclose. B.M.B. reports funding from the National Institutes of Health/National Cancer Institute, Harvard TH Chan-NIEHS Center, and American Institute for Cancer Research and honoraria from Harvard University outside the submitted work. J.W.R.-E. reports funding from the US National Institutes of Health for the submitted work. Y.-X.W. has nothing to disclose. R.M.T. has nothing to disclose. S.A.M. reports funding from the US National Institutes of Health for the submitted work; funding from AbbVie, Department of Defense, and Marriot Family Foundations; honoraria from University British Columbia, WERF, and Huilun Shanghai; travel support from ESHRE 2020, Society for Reproductive Investigation – 69th Annual Scientific Meeting (2022), ESHRE 2022, FWGBD 2022, University of Michigan, Massachusetts Institute of Technology, and ASRM 2022; personal fees from the advisory board of AbbVie and Roche, Frontiers in Reproductive Health Field Chief Editor, and Abbott Roundtable participation; and leadership roles with the SWHR, WERF, WES, ASRM, and ESHRE outside the submitted work. J.E.C. reports funding from the National Institutes of Health and Food and Drug Administration; royalties from Harvard University; honoraria from Johns Hopkins University School of Medicine, National Institutes of Health, Northwestern University Feinberg School of Medicine, Carolinas Medical Center, American Society for Reproductive Medicine, British Dietetic Association, Pacific Coast Reproductive Society, Tufts University, and Zheijang University School of Medicine (China); and travel support from Johns Hopkins University School of Medicine, Pacific Coast Reproductive Society, European Society of Human Reproduction and Embryology, Health Sciences University School of Medicine (Colombia), Institut Hospital del Mar d'Investigacions Mediques (Spain), Japanese Society for Reproductive Medicine (Japan), Zheijang University School of Medicine (China), Lund University Faculty of Medicine (Sweden), and Medical University of Vienna (Austria) outside the submitted work.
Publisher Copyright:
© 2023 American Society for Reproductive Medicine
PY - 2023/7
Y1 - 2023/7
N2 - Objective: To investigate the association between infertility and the incidence of invasive cancer. Design: Prospective cohort study (1989–2015). Setting: Not applicable. Patient(s): A total of 103,080 women aged 25–42 years in the Nurses’ Health Study II who were cancer-free at baseline (1989). Intervention(s): The infertility status (failure to conceive after 1 year of regular, unprotected sex) and causes of infertility were self-reported at baseline and biennial follow-up questionnaires. Main Outcome Measure(s): Cancer diagnosis was confirmed through medical record review and classified as obesity-related (colorectal, gallbladder, kidney, multiple myeloma, thyroid, pancreatic, esophageal, gastric, liver, endometrial, ovarian, and postmenopausal breast) or non–obesity-related (all other cancers). We fit the Cox proportional-hazards models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the association between infertility and cancer incidence. Result(s): During 2,149,385 person-years of follow-up, 26,208 women reported a history of infertility, and we documented 6,925 incident invasive cancer cases. After adjusting for body mass index and other risk factors, women who reported infertility had a higher risk of developing cancer than gravid women without a history of infertility (HR, 1.07; 95% CI, 1.02–1.13). This association was stronger among obesity-related cancers (HR, 1.13; 95% CI, 1.05–1.22; vs. non–obesity-related cancers, HR, 0.98; 95% CI, 0.91–1.06) and, in particular, obesity-related reproductive cancers (postmenopausal breast, endometrial, and ovarian cancers; HR, 1.17; 95% CI, 1.06–1.29) and was stronger among women who first reported infertility earlier in life (≤25 years, HR, 1.19; 95% CI, 1.07–1.33; 26–30 years, HR, 1.11; 95% CI, 0.99–1.25; >30 years, HR, 1.07; 95% CI, 0.94–1.22; P trend < .001). Conclusion(s): A history of infertility may be associated with the risk of developing obesity-related reproductive cancers; further study is needed to elucidate the underlying mechanisms.
AB - Objective: To investigate the association between infertility and the incidence of invasive cancer. Design: Prospective cohort study (1989–2015). Setting: Not applicable. Patient(s): A total of 103,080 women aged 25–42 years in the Nurses’ Health Study II who were cancer-free at baseline (1989). Intervention(s): The infertility status (failure to conceive after 1 year of regular, unprotected sex) and causes of infertility were self-reported at baseline and biennial follow-up questionnaires. Main Outcome Measure(s): Cancer diagnosis was confirmed through medical record review and classified as obesity-related (colorectal, gallbladder, kidney, multiple myeloma, thyroid, pancreatic, esophageal, gastric, liver, endometrial, ovarian, and postmenopausal breast) or non–obesity-related (all other cancers). We fit the Cox proportional-hazards models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the association between infertility and cancer incidence. Result(s): During 2,149,385 person-years of follow-up, 26,208 women reported a history of infertility, and we documented 6,925 incident invasive cancer cases. After adjusting for body mass index and other risk factors, women who reported infertility had a higher risk of developing cancer than gravid women without a history of infertility (HR, 1.07; 95% CI, 1.02–1.13). This association was stronger among obesity-related cancers (HR, 1.13; 95% CI, 1.05–1.22; vs. non–obesity-related cancers, HR, 0.98; 95% CI, 0.91–1.06) and, in particular, obesity-related reproductive cancers (postmenopausal breast, endometrial, and ovarian cancers; HR, 1.17; 95% CI, 1.06–1.29) and was stronger among women who first reported infertility earlier in life (≤25 years, HR, 1.19; 95% CI, 1.07–1.33; 26–30 years, HR, 1.11; 95% CI, 0.99–1.25; >30 years, HR, 1.07; 95% CI, 0.94–1.22; P trend < .001). Conclusion(s): A history of infertility may be associated with the risk of developing obesity-related reproductive cancers; further study is needed to elucidate the underlying mechanisms.
KW - Infertility
KW - cancer
KW - endometrial cancer
KW - ovarian cancer
KW - postmenopausal breast cancer
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U2 - 10.1016/j.fertnstert.2023.02.028
DO - 10.1016/j.fertnstert.2023.02.028
M3 - Article
C2 - 36849034
AN - SCOPUS:85153310487
SN - 0015-0282
VL - 120
SP - 134
EP - 142
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 1
ER -