Can Polycystic Ovary Syndrome (PCOS) Cause Cancer?

What is PCOS?

PCOS is an endocrine disorder affecting the system that regulates hormones throughout the bodies of women of childbearing age (the endocrine system). Essentially, a woman living with PCOS has a body that produces more androgen, thought to be due to intrinsic defects in the ovaries. The increased level of androgen does impact the body, but PCOS is treatable and can be managed throughout life. 

There are many symptoms of PCOS that present themselves in the body. Due to widespread literature on the topic and medical discussions about PCOS, you may come to realize there is a potential connection between this diagnosis and developing cancer. However, the current research suggests that excess odds of developing endometrial cancer are low in PCOS. The excess risk in a meta-analysis was shown to be having an odds ratio of 2.79, 95% CI 1.31-5.95.¹

As with all chronic conditions, understanding the relationship between your body and PCOS changes over time. It is also important to learn about the development of cancer in order to mitigate its progress. Then, you can plan how to test for cancerous cells and treat them if they arise. 

PCOS itself is often diagnosed when one experiences a set of symptoms that mainly stem from androgen excess. 

Here is a list of some common symptoms and signs seen with PCOS:

• Irregular periods

• The formation of cysts in the ovaries 

• Male pattern hair loss

• Trouble conceiving a child 

• Acne and extra hair growth (hirsutism) 

For instance, you may be prescribed birth control pills to regulate your cycle and combat signs and symptoms of hyperandrogenism, such as hirsutism. In addition to infertility, PCOS is associated with diabetes and cancer later in life. Although the symptoms you will experience throughout your life may be unknown, and the treatments may change, PCOS is a manageable condition. 

Does PCOS cause cancer? 

You may wonder whether PCOS can cause breast cancer, ovarian cancer, uterine cancer, and other reproductive system cancers. It is not uncommon to feel apprehensive, but researchers are continuing PCOS clinical trials to support better knowledge and understanding of the condition. 

PCOS-associated cancer is endometrial cancer (cancer that develops inside the walls of the uterus). As the NIH details, "Irregular periods, or a lack of periods, can cause the endometrium to build up and become thick. This thickening can lead to endometrial cancer." Basically, the uterine wall is different when it doesn't experience regular shedding, as it is continually under estrogenic stimulation with no progesterone for differentiation.

A meta-analysis has demonstrated that PCOS increased the risk of endometrial cancer but not that of breast cancer and ovarian cancer, particularly for women under 54 years of age. Research scientists must run studies to establish causality and association. 

If more cancers associated with PCOS are one day identified, it will only mean testing for and treating it to allow women to continue living the best life possible. In other words, clinical trials are crucial but not something that should dim the mood and happiness of those who may one day be impacted by a currently unknown connection. 

Managing cancer risk factors while having PCOS

Women with PCOS may feel increased anxiety when reading and learning about PCOS. The National Cancer Institute has developed a Guide for Endometrial Cancer Prevention. They outline several factors that increase the risk of endometrial cancer, as well as behaviors and patterns that lessen it. There are controllable factors and ones that cannot be managed. However, they do recommend several lifestyle changes that contribute to overall better health. Other changes are very PCOS-specific. 

Factors that individuals can control that are worth considering include:

• Avoid taking tamoxifen 

• Manage obesity and weight gain with regular exercise

From a monitoring standpoint, there is no consensus on monitoring endometrium in women with PCOS. However, one study suggested that an endometrial thickness of less than 7mm on transvaginal ultrasound was not associated with histologic evidence of endometrial hyperplasia.

The lowdown

PCOS may be associated with some objectively negative potential scenarios compared to those without the condition (i.e., a possible increased risk of endometrial cancer). Improving general health conditions can help mitigate risk, although continued research is being conducted to learn more about PCOS-associated conditions. 

Additional clinical trials and research will be vital in understanding the broader impact of PCOS, as well as methods to improve healthcare initiatives for those affected.