Cancer in women after assisted reproductive technology.
OBJECTIVE
To evaluate the risk of cancer after assisted reproductive technology (ART) therapy.


METHODS
Longitudinal cohort study.


METHODS
Not applicable.


METHODS
New York, Texas, and Illinois residents between 2004 and 2009, treated with ART, comprising cycles of 113,226 women, including 53,859 women without prior ART treatment, who were linked to their respective state cancer registries and whose cycles were reported to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS).


METHODS
None.


METHODS
Diagnosis of cancer, as reported to the state cancer registry; standardized incidence ratios (SIR) and their 95% confidence intervals, comparing the observed to expected cancer cases based on age-specific cancer rates in the general population of each state.


RESULTS
Among the cohort of women without prior ART therapy, hazard ratios (HR) and 95% confidence intervals (CI) were calculated for treatment parameters and reproductive history factors. The mean follow-up period was 4.87 years; among women without prior ART, 450 women developed 460 cancers. Women treated with ART had a statistically significantly lower risk for all cancers (for all women: SIR 0.78; CI, 0.73-0.83; women without prior ART: SIR 0.75; CI, 0.68-0.82), breast cancer, and all female genital cancers; a non-statistically-significant lower risk for endocrine and uterine cancer; and a non-statistically-significant higher risk for melanoma and ovarian cancer. Among women without prior ART, we found no statistically significant increased HR by parity, number of cycles, cumulative follicle-stimulating hormone dosage, or cycle outcome.


CONCLUSIONS
Women initiating ART treatment have no greater risk for developing cancer after nearly 5 years of follow-up compared with the general population and with other women treated with ART.
Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, Michigan. Electronic address: lukeb@msu.edu.
Barbara
B
Luke
Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan.
Morton B
MB
Brown
Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
Logan G
LG
Spector
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Stacey A
SA
Missmer
Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, Michigan.
Richard E
RE
Leach
Texas Cancer Registry, Cancer Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas.
Melanie
M
Williams
Illinois State Cancer Registry, Illinois Department of Public Health, Springfield, Illinois.
Lori
L
Koch
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
Yolanda
Y
Smith
Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Judy E
JE
Stern
Seattle Reproductive Medicine, Seattle, Washington.
G David
GD
Ball
Bureau of Cancer Epidemiology, New York State Cancer Registry, New York State Department of Health, Albany, New York.
Maria J
MJ
Schymura
D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D011247:Pregnancy; D065840:Protective Factors; D012042:Registries; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
Assisted reproductive technology; cancer risk; fertility; pregnancy outcome