Cancer Risk

Polycystic ovary syndrome is a common reproductive disorder resulting in a disruption of

normal reproductive physiology. This condition may be associated with increased risk of the
development of cancer of the endometrium, ovary, and/ or breast, either directly or mediated by
its associated reproductive- metabolic alterations. There is a small to moderate amount of
literature assessing the association of PCOS with the development of cancer of the reproductive
organs. Estimates of the strength of association are likely to be sensitive to a number of factors
including limitations in the definition of PCOS, limitations in comparison with various
populations, and the small number of studies assessing each cancer type (50, 52, 55, 56).
Conclusions (Agreement)
There are moderate quality data to support that women with PCOS have a 2.7-fold (95%
confidence interval [CI], 1.07.3) increased risk for endometrial cancer. Most
endometrial cancers are well differentiated and have a good prognosis (level B).
Limited data exist that do not support the conclusion that women with PCOS are at
increased risk for ovarian cancer (level B)
Limited data exist that do not support the conclusion that women with PCOS are at
increased risk for breast cancer (level B).
Impact of Interventions on Quality of Life
Weight loss has been the main target of interventions. An RCT was conducted of metformin
versus placebo and incorporated a 24-week lifestyle modification program (LMP) for
adolescents with PCOS and their parents. All PCOSQ domains of QOL improved from baseline
to immediately after intervention (94). Effects of a 24-week LMP focused on changing physical
activity level or diet (depending on patient preference) in obese women with PCOS were also
studied. There was no difference between the activity and diet groups on frequency of sexual
activity (only QOL outcome), but physical and biochemical outcomes improved after both
interventions (104). Women with PCOS randomized to diet only, diet and aerobic exercise, or
diet and combined aerobic-resistance exercise showed significant decreases in depression scores
by week 10, with no further change by the end of the program (week 20) (103). Improvements in
PCOSQ subscales of emotion, body weight, and menstrual problems were also clinically
significant. Finally, an investigation of laser surgery showed significantly improved QOL scores
after five treatments (laser hair removal) (105). Participants of a nurse-led support group
(providing emotional expression and support) for patients with PCOS were interviewed, and
qualitative analysis reported the benefits in increased knowledge, reduced isolation, and enabling
change (106).