Effects of fertility drugs on cancers other than breast and gynecologic malignancies.

Abstract

OBJECTIVE:

To examine the relationship of ovulation-stimulating drugs to risk of cancers other than breast and gynecologic malignancies.

DESIGN:

Retrospective cohort study, with additional follow-up since initial report.

SETTING:

Reproductive endocrinology practices.

PATIENT(S):

Among a cohort of 12,193 women evaluated for infertility between 1965 and 1988, a total of 9,892 women (81.1% of the eligible population) were followed through 2010, via passive and active (questionnaire) approaches.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Hazard ratios (HRs) and 95% confidence intervals (CIs) for various fertility treatment parameters for select cancers.

RESULT(S):

During 30.0 median years of follow-up (285,332 person-years), 91 colorectal cancers, 84 lung cancers, 55 thyroid cancers, and 70 melanomas were diagnosed among study subjects. Clomiphene citrate (CC), used by 38.1% of patients, was not associated with colorectal or lung cancer risks, but was related significantly to melanoma (HR = 1.95; 95% CI: 1.18-3.22), and non-significantly to thyroid cancer risks (HR = 1.57; 95% CI: 0.89-2.75). The highest melanoma risks were seen among those with the lowest drug exposure levels, but thyroid cancer risk was greatest among the heavily exposed patients (HR = 1.96; 95% CI: 0.92-4.17 for those receiving >2,250 mg). Clomiphene citrate-associated risks for thyroid cancer were somewhat higher among nulligravid, compared with gravid, women, but did not differ according to distinct causes of infertility. Gonadotropins, used by only 9.7% of subjects, were not related to risk of any of the assessed cancers.

CONCLUSION(S):

Our results provide support for continued monitoring of both melanoma and thyroid cancer risk among patients receiving fertility drugs.

• Authors: Louise A Brinton, Kamran S Moghissi, Bert Scoccia, Emmet J Lamb, Britton Trabert, Shelley Niwa, David Ruggieri, Carolyn L Westhoff
• Journal: Fertility and sterility (Fertil Steril) Vol. 104 Issue 4 Pg. 980-988 (Oct 2015) ISSN: 1556-5653 [Electronic] United States
• PMID: 26232746 (Publication Type: Journal Article, Research Support, N.I.H., Intramural)
• Copyright: Published by Elsevier Inc.

Chemical References

• Fertility Agents, Female

Topics

• Adult
• Breast Neoplasms (epidemiology)
• Colorectal Neoplasms (epidemiology)
• Female
• Fertility Agents, Female (pharmacology, therapeutic use)
• Follow-Up Studies
• Genital Neoplasms, Female (epidemiology)
• Humans
• Infertility, Female (drug therapy, epidemiology)
• Lung Neoplasms (epidemiology)
• Melanoma (epidemiology)
• Middle Aged
• Neoplasms (epidemiology)
• Pregnancy
• Retrospective Studies
• Thyroid Neoplasms (epidemiology)