title: Preventing endometrial cancer risk in polycystic ovarian syndrome (PCOS) women: could metformin help?
abstract: Current data indicate that there is a significant risk of endometrial cancer (EC) in women with polycystic ovarian syndrome (PCOS), although further research needed to clarify the exact molecular mechanisms. Endometrial hyperplasia is a premalignant condition that usually heralds EC and it shares identical risk factors with EC. Metabolic syndrome with a triad of obesity, hyperinsulinaemia and diabetes, which is commonly observed in PCOS appears to be a key mechanism in EC pathogenesis. Measures to improve insulin resistance could therefore play a role in reducing the risk of EC in women with PCOS. Metformin is an insulin sensitising agent which is safe, widely available and currently licensed for type-2 diabetes. It has been clearly shown in both animal and human studies that metformin is of value in reversing endometrial hyperplasia. Metformin may therefore prevent EC in PCOS. This article reviews the use of metformin in reducing EC risk in PCOS and makes a case for future research on this topic.
authors.affiliation: The Division of Obstetrics and Gynaecology and Child Health, School of Medicine, D Floor, East Block, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Derby Road, NG7 2UH, United Kingdom; The Department of Obstetrics and Gynaecology, Faculty of Medicine, UKM Medical Centre, Kuala Lumpur, 56000, Malaysia. Electronic address: mgxmnsh@nottingham.ac.uk.
authors.forename: Mohamad Nasir
authors.initials: MN
authors.lastname: Shafiee
authors.affiliation: The Division of Obstetrics and Gynaecology and Child Health, School of Medicine, D Floor, East Block, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Derby Road, NG7 2UH, United Kingdom.
authors.forename: Gulafshana
authors.initials: G
authors.lastname: Khan
authors.affiliation: The Department of Obstetrics and Gynaecology, Faculty of Medicine, UKM Medical Centre, Kuala Lumpur, 56000, Malaysia.
authors.forename: Rina
authors.initials: R
authors.lastname: Ariffin
authors.affiliation: The Department of Obstetrics and Gynaecology, City Hospital, Hucknall Road, NG5 1PB, United Kingdom.
authors.forename: Jafaru
authors.initials: J
authors.lastname: Abu
authors.affiliation: Centre of Excellence for Autoimmunity in Cancer, School of Graduate Entry Medicine and Health, University of Nottingham, NG5 1PB, United Kingdom.
authors.forename: Caroline
authors.initials: C
authors.lastname: Chapman
authors.affiliation: Department of Histopathology, A Floor, East Block, Queen's Medical Centre, Nottingham University Hospital NHS Trust, United Kingdom.
authors.forename: Suha
authors.initials: S
authors.lastname: Deen
authors.affiliation: The Department of Obstetrics and Gynaecology, City Hospital, Hucknall Road, NG5 1PB, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Nunns
authors.affiliation: Centre for Analytical Bioscience, School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD, United Kingdom.
authors.forename: David A
authors.initials: DA
authors.lastname: Barrett
authors.affiliation: The School of Molecular Biology, Clinical Sciences Building, University of Nottingham, Hucknall Road, NG5 1PB, United Kingdom.
authors.forename: Claire
authors.initials: C
authors.lastname: Seedhouse
authors.affiliation: The Division of Obstetrics and Gynaecology and Child Health, School of Medicine, D Floor, East Block, Queen's Medical Centre, Nottingham University Hospital NHS Trust, Derby Road, NG7 2UH, United Kingdom.
authors.forename: William
authors.initials: W
authors.lastname: Atiomo
mesh_terms: D004714:Endometrial Hyperplasia / Q000150:complications; D016889:Endometrial Neoplasms / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008687:Metformin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy*; D011374:Progesterone / Q000627:therapeutic use; D012306:Risk
chemical_list: D011374:Progesterone; D008687:Metformin
keywords: Endometrial cancer; Endometrial hyperplasia; Metformin; PCOS