Risk of uterine, ovarian and breast cancer following pelvic inflammatory disease: a nationwide population-based retrospective cohort study.

Cheng-Che Shen,Jeng-Hsiu Hung,Shih-Jen Tsai,Yung-Yen Chiang,Albert C Yang,Li-Yu Hu

doi:10.1186/s12885-016-2857-1

Abstract

BackgroundPelvic inflammatory disease (PID) is characterized by infection and inflammation of the upper genital tract in women and is associated with health sequelae. We used a nationwide population-based retrospective cohort study to explore the relationship between PID and the subsequent development of gynecological cancers including ovarian, breast or uterine cancer.MethodsWe identified subjects diagnosed with PID between January 1st, 2000 and December 31st, 2002 in the Taiwan National Health Insurance Research Database. A comparison cohort constructed for patients without PID were matched according to age and sex. All PID patients and control groups were observed until diagnosed with ovarian, breast or uterine cancer, or until death, withdrawal from the NHI system, or until December 31st, 2009.ResultsThe PID cohort consisted of 32,268 patients, and an equal number of matched controls without PID. The adjusted hazard ratio (HR) of ovarian, breast or uterine cancer in subjects with PID were: HR 1.326 (95 % confidence interval: 0.775–2.269), HR: 1.039 (95 % confidence interval: 0.862–1.252), and HR: 1.439 (95 % confidence interval: 0.853–2.426) respectively in comparison with controls during follow-up.ConclusionsThis large nationwide population-based cohort study suggests that there is no increased risk for ovarian, breast or uterine cancer among women who have PID compared to a matching population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2857-1) contains supplementary material, which is available to authorized users.

Highlights

Pelvic inflammatory disease (PID) is characterized by infection and inflammation of the upper genital tract in women and is associated with health sequelae
The first aim of this study is to explore whether PID increases the risk of developing ovarian cancer with the same database (Longitudinal Health Insurance Database 2005, LHID2005), but with a longer follow-up period excluding ICD-9-CM code 616 in PID cases
Comorbidities, including hypertension, diabetes mellitus, dyslipidemia, congestive heart failure, cerebrovascular disease and chronic pulmonary disease were more common in PID patients than controls

Summary

Introduction

Pelvic inflammatory disease (PID) is characterized by infection and inflammation of the upper genital tract in women and is associated with health sequelae. Pelvic inflammatory disease (PID) is a polymicrobial infection and inflammatory disorder of the upper female genital tract, including the uterus, fallopian tubes, and adjacent pelvic structures in women [1, 2]. Patients with International Classification of Diseases, ninth revision, clinical modification (ICD-9-CM) code 616 (inflammatory disease of cervix, vagina, and vulva) could have been wrongly classified in PID cases in that study [8] For these reasons, the first aim of this study is to explore whether PID increases the risk of developing ovarian cancer with the same database (Longitudinal Health Insurance Database 2005, LHID2005), but with a longer follow-up period excluding ICD-9-CM code 616 in PID cases. The second aim of this study to investigate whether women with PID raise the risk of developing uterine or breast cancer

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