Cancer in women after assisted reproductive technology

Barbara Luke, Morton B. Brown, Logan G. Spector, Stacey A. Missmer, Richard E. Leach, Melanie Williams, Lori Koch, Yolanda Smith, Judy E. Stern, G. David Ball, Maria J. Schymura

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective To evaluate the risk of cancer after assisted reproductive technology (ART) therapy. Design Longitudinal cohort study. Setting Not applicable. Patient(s) New York, Texas, and Illinois residents between 2004 and 2009, treated with ART, comprising cycles of 113,226 women, including 53,859 women without prior ART treatment, who were linked to their respective state cancer registries and whose cycles were reported to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS). Intervention(s) None. Main Outcome Measure(s) Diagnosis of cancer, as reported to the state cancer registry; standardized incidence ratios (SIR) and their 95% confidence intervals, comparing the observed to expected cancer cases based on age-specific cancer rates in the general population of each state. Result(s) Among the cohort of women without prior ART therapy, hazard ratios (HR) and 95% confidence intervals (CI) were calculated for treatment parameters and reproductive history factors. The mean follow-up period was 4.87 years; among women without prior ART, 450 women developed 460 cancers. Women treated with ART had a statistically significantly lower risk for all cancers (for all women: SIR 0.78; CI, 0.73-0.83; women without prior ART: SIR 0.75; CI, 0.68-0.82), breast cancer, and all female genital cancers; a non-statistically-significant lower risk for endocrine and uterine cancer; and a non-statistically-significant higher risk for melanoma and ovarian cancer. Among women without prior ART, we found no statistically significant increased HR by parity, number of cycles, cumulative follicle-stimulating hormone dosage, or cycle outcome. Conclusion(s) Women initiating ART treatment have no greater risk for developing cancer after nearly 5 years of follow-up compared with the general population and with other women treated with ART.

Original languageEnglish (US)
Pages (from-to)1218-1226
Number of pages9
JournalFertility and Sterility
Volume104
Issue number5
DOIs
StatePublished - Nov 2015

Fingerprint

Assisted Reproductive Techniques
Neoplasms
Confidence Intervals
Registries
Incidence
Endocrine Gland Neoplasms
Therapeutics
Reproductive History
Uterine Neoplasms
Follicle Stimulating Hormone
Parity
Ovarian Neoplasms
Population
Longitudinal Studies
Melanoma
Cohort Studies
Outcome Assessment (Health Care)
Breast Neoplasms

Keywords

  • Assisted reproductive technology
  • cancer risk
  • fertility
  • pregnancy outcome

PubMed: MeSH publication types

  • Journal Article
  • Multicenter Study
  • Research Support, N.I.H., Extramural

Cite this

Luke, B., Brown, M. B., Spector, L. G., Missmer, S. A., Leach, R. E., Williams, M., ... Schymura, M. J. (2015). Cancer in women after assisted reproductive technology. Fertility and Sterility, 104(5), 1218-1226. https://doi.org/10.1016/j.fertnstert.2015.07.1135

Cancer in women after assisted reproductive technology. / Luke, Barbara; Brown, Morton B.; Spector, Logan G.; Missmer, Stacey A.; Leach, Richard E.; Williams, Melanie; Koch, Lori; Smith, Yolanda; Stern, Judy E.; Ball, G. David; Schymura, Maria J.

In: Fertility and Sterility, Vol. 104, No. 5, 11.2015, p. 1218-1226.

Research output: Contribution to journalArticle

Luke, B, Brown, MB, Spector, LG, Missmer, SA, Leach, RE, Williams, M, Koch, L, Smith, Y, Stern, JE, Ball, GD & Schymura, MJ 2015, 'Cancer in women after assisted reproductive technology', Fertility and Sterility, vol. 104, no. 5, pp. 1218-1226. https://doi.org/10.1016/j.fertnstert.2015.07.1135
Luke, Barbara ; Brown, Morton B. ; Spector, Logan G. ; Missmer, Stacey A. ; Leach, Richard E. ; Williams, Melanie ; Koch, Lori ; Smith, Yolanda ; Stern, Judy E. ; Ball, G. David ; Schymura, Maria J. / Cancer in women after assisted reproductive technology. In: Fertility and Sterility. 2015 ; Vol. 104, No. 5. pp. 1218-1226.
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abstract = "Objective To evaluate the risk of cancer after assisted reproductive technology (ART) therapy. Design Longitudinal cohort study. Setting Not applicable. Patient(s) New York, Texas, and Illinois residents between 2004 and 2009, treated with ART, comprising cycles of 113,226 women, including 53,859 women without prior ART treatment, who were linked to their respective state cancer registries and whose cycles were reported to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS). Intervention(s) None. Main Outcome Measure(s) Diagnosis of cancer, as reported to the state cancer registry; standardized incidence ratios (SIR) and their 95{\%} confidence intervals, comparing the observed to expected cancer cases based on age-specific cancer rates in the general population of each state. Result(s) Among the cohort of women without prior ART therapy, hazard ratios (HR) and 95{\%} confidence intervals (CI) were calculated for treatment parameters and reproductive history factors. The mean follow-up period was 4.87 years; among women without prior ART, 450 women developed 460 cancers. Women treated with ART had a statistically significantly lower risk for all cancers (for all women: SIR 0.78; CI, 0.73-0.83; women without prior ART: SIR 0.75; CI, 0.68-0.82), breast cancer, and all female genital cancers; a non-statistically-significant lower risk for endocrine and uterine cancer; and a non-statistically-significant higher risk for melanoma and ovarian cancer. Among women without prior ART, we found no statistically significant increased HR by parity, number of cycles, cumulative follicle-stimulating hormone dosage, or cycle outcome. Conclusion(s) Women initiating ART treatment have no greater risk for developing cancer after nearly 5 years of follow-up compared with the general population and with other women treated with ART.",
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