Abstract
BackgroundThe association of complications of pregnancy and the risk of developing gynecological cancer is controversial with the limited study. In this study, we investigated the association of preeclampsia, or gestational diabetes mellitus (GDM), or large for gestational age (LGA), or intrauterine growth restriction (IUGR) and the risk of endometrial or ovarian cancer.MethodsIn this case-control study, 189 women with endometrial cancer and 119 women with ovarian cancer were included. 342 women without gynecological cancers were randomly selected as a control group. Data on the history of pregnancy and age at diagnosis of gynecological cancer as well as the use of intrauterine devices (IUDs) were collected.ResultsWomen with a history of preeclampsia or IUGR did not have an increased risk of developing endometrial or ovarian cancer. While women with a history of GDM or with the delivery of LGA infant increased the risk of developing endometrial cancer but not ovarian cancer. The odds of women with a history of GDM or with the delivery of LGA infant developing endometrial cancer was 2.691 (95% CI: 1.548, 4.3635, p=0.0003), or 6.383 (95% CI: 2.812, 13.68, p<0.0001) respectively, compared to the controls. The odds ratio of women who did not use IUDs developing ovarian cancer was 1.606 (95% CI: 1.057, 2.434), compared to the controls. There was no association of age at first birth and developing endometrial or ovarian cancer.ConclusionOur observational data suggested that GDM and delivery of an LGA infant are associated with an increased risk of endometrial cancer.
Highlights
Endometrial and ovarian cancers are most common gynecological cancer worldwide [1]
We investigated the association of preeclampsia, or gestational diabetes mellitus (GDM), or large for gestational age (LGA), or intrauterine growth restriction (IUGR) and the risk of endometrial or ovarian cancer
While women with a history of GDM or with the delivery of LGA infant increased the risk of developing endometrial cancer but not ovarian cancer
Summary
Endometrial and ovarian cancers are most common gynecological cancer worldwide [1]. Despite the risk of cancer being greatly dependent on lifestyle factors, which may in many ways be different between multiparous and nulliparous women, strong evidence has previously suggested that women with multiparous have significantly decreased the incidence of endometrial and ovarian cancer [2,3,4,5,6]. A recent study further reported that women with multiparous delay the time of developing endometrial cancer [7]. A recent study reported that women with multiparous have a similar overall risk of developing non-gynecological cancers compared to women with a lower parity [8]. Elevated progesterone levels during pregnancy could inhibit estrogen-driven endometrial cell proliferation and promote differentiation and apoptosis of endometrial cells [14, 15]. It is well-known that breasting feeding significantly reduces gynecological cancer development [16], which could be due to the reduced ovulation. We investigated the association of preeclampsia, or gestational diabetes mellitus (GDM), or large for gestational age (LGA), or intrauterine growth restriction (IUGR) and the risk of endometrial or ovarian cancer
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