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Colorectal cancer risk increased with IVF vs. other subfertility treatments
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Results of a large cohort nationwide study in The Netherlands have shown that risk for colorectal cancer was not increased for patients that had ovarian stimulation with in-vitro fertilization compared to the general population; however, the risk was found to be higher in these patients, compared to patients that underwent other subfertility treatments.
Researchers at the department of epidemiology, The Netherlands Cancer Institute, Amsterdam, and the department of obstetrics and gynecology, Erasmus Medical Center, Rotterdam, The Netherlands, examined cancer risk in patients who received ovarian stimulation for in-vitro fertilization (IVF) compared to patients who underwent subfertility treatments other than IVF and compared them to the general population. The cohort consisted of 19,158 women in the IVF group and 5,950 women who had other subfertility treatments (the non-IVF group). The researchers used the Netherlands Cancer Registry to obtain cancer data and followed patients for a median of 21 years. The cohort of women was identified in 1996 and included women who underwent IVF treatments between 1983 and 1995, and women who underwent other fertility treatments between 1980 and 1995.
Women in the IVF group, compared to the non-IVF group, had similar subfertility diagnoses. The majority of the women that did not have IVF underwent tubal surgery, intrauterine insemination, hormonal treatments or withdrew from the waiting list for IVF.
A total of 109 CRCs occurred in both groups. In the IVF group, CRC was not increased compared to the general population (standardized incidence ratio = 1; 95% confidence interval [CI], 0.8-1.23). The risk of CRC was increased in the IVF group compared to the non-IVF group (multivariable-adjusted hazard ratio = 1.8; 95% CI, 1.1-2.94). Risk of CRC was significantly decreased in the non-IVF group, compared to the general population (SIR = 0.58; 95% CI, 0.36-0.88).
“Reassuringly, after a median follow-up of 21 years, IVF-treated women did not have an increased risk of colorectal cancer compared with the general population and women who received subfertility treatments other than IVF even had a significantly decreased risk. However, risk in the IVF group was significantly increased (1.8-fold) compared with the non-IVF group. Although lack of a dose-response relationship with more IVF treatment cycles does not support a causal association with colorectal cancer risk, more research is warranted to examine the effects of ovarian stimulation for IVF on colorectal cancer risk,” the researchers wrote.
Disclosures: The researchers report no relevant financial disclosures.
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