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Fertility drug use not associated with increase in risk for ovarian cancer
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Though fertility drug use was not associated with overall risk, clomiphene use was associated with a 67% increase in the risk for serous ovarian carcinoma, according to data from a Danish population based cohort study.
The study included 54,362 women referred to Danish fertility clinics between 1963 and 1998. At first infertility evaluation, the median age was 30 years; the median age at the end of follow-up was 47 years. The study also included 156 women with invasive epithelial ovarian cancer and a subcohort of 1,241 women identified during follow-up. Forty-nine percent of women with ovarian cancer and 50% of those in the subcohort had used fertility drugs.
The researchers assessed the cancer risk associated with four groups of fertility drugs, including: gonadotropins, clomiphene citrate, human chorionic gonadotropin and gonadotropin-releasing hormone. According to the researchers, the overall risk for ovarian cancer was not associated with the use of any fertility drug (rate ratio=1.03; 95% CI, 0.73-1.47). The number of cycles of use and years since first use of fertility drug did not significantly affect cancer risk among the different groups. Similarly, the risk was not affected by parity for all four types of drugs.
Researchers reported that the risk for serous cancers was significantly higher after using clomiphene (RR=1.67; 95% CI, 1.07-2.61); the risk was observed most in women followed for ≥15 years after first use of clomiphene, compared with never users (<5 years, RR=1.22; 5 to 9 years, RR=1.76; 10 to 14 years, RR=1.23; ≥15 years, RR= 2.17).
BMJ. 2009;338:b249.