title: In situ and invasive cervical carcinoma in a cohort of infertile women.
abstract: OBJECTIVE
  To assess the risk of cervical neoplasia associated with the use of ovulation-inducing agents such as clomiphene citrate (CC) DESIGN: Case-cohort study.
  
  
  METHODS
  Infertility clinics in Seattle, Washington.
  
  
  METHODS
  A cohort of 3,837 women evaluated for infertility at some time during 1974-1985.
  
  
  METHODS
  Computer linkage with a population-based tumor registry was used to identify women diagnosed with cervical cancer before January 1, 1992. Data regarding infertility testing and treatment were abstracted from medical records for women who developed cancer and a randomly selected subcohort.
  
  
  RESULTS
  Thirty-six women in the cohort developed in situ or invasive cervical cancer in comparison with an expected number of 67.8 cases (standardized incidence ratio = 0.5, 95% confidence interval [CI] 0.4 to 0.7). Infertile women with fallopian tube abnormalities were at an increased risk of cervical cancer relative to women whose infertility was believed to be due to other causes. The risk among women who had taken CC was reduced relative to infertile women who had not used this drug (relative risk = 0.4, 95% CI 0.2 to 0.8). This association was present both in women with and without tubal abnormalities. However, the size of the reduction in risk was not influenced by duration of use.
  
  
  CONCLUSIONS
  The hypothesis that use of antiestrogenic agents, such as CC, can lead to a reduced risk of cervical neoplasia warrants testing in other studies.
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington 98104, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Rossing
authors.forename: J R
authors.initials: JR
authors.lastname: Daling
authors.forename: N S
authors.initials: NS
authors.lastname: Weiss
authors.forename: D E
authors.initials: DE
authors.lastname: Moore
authors.forename: S G
authors.initials: SG
authors.lastname: Self
mesh_terms: D000328:Adult; D002278:Carcinoma in Situ / Q000139:chemically induced*; D016022:Case-Control Studies; D002996:Clomiphene / Q000009:adverse effects*; D005260:Female; D005300:Fertility Agents, Female / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D012306:Risk; D002583:Uterine Cervical Neoplasms / Q000139:chemically induced*
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene