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dc.contributor.authorWilliams, CL
dc.contributor.authorJones, ME
dc.contributor.authorSwerdlow, AJ
dc.contributor.authorBotting, BJ
dc.contributor.authorDavies, MC
dc.contributor.authorJacobs, I
dc.contributor.authorBunch, KJ
dc.contributor.authorMurphy, MFG
dc.contributor.authorSutcliffe, AG
dc.date.accessioned2019-01-16T14:37:52Z
dc.date.issued2018-07-11
dc.identifier.citationBMJ (Clinical research ed.), 2018, 362 pp. k2644 - ?
dc.identifier.issn0959-8138
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3005
dc.identifier.eissn1756-1833
dc.identifier.doi10.1136/bmj.k2644
dc.description.abstractOBJECTIVE: To investigate the risks of ovarian, breast, and corpus uteri cancer in women who have had assisted reproduction. DESIGN: Large, population based, data linkage cohort study. SETTING AND PARTICIPANTS: All women who had assisted reproduction in Great Britain, 1991-2010, as recorded by the Human Fertilisation and Embryology Authority (HFEA). INTERVENTIONS: HFEA fertility records for cohort members were linked to national cancer registrations. MAIN OUTCOME MEASURES: Observed first diagnosis of ovarian, breast, and corpus uteri cancer in cohort members were compared with age, sex, and period specific expectation. Standardised incidence ratios (SIRs) were calculated by use of age, sex, and period specific national incidence rates. RESULTS: 255 786 women contributed 2 257 789 person years' follow-up. No significant increased risk of corpus uteri cancer (164 cancers observed v 146.9 cancers expected; SIR 1.12, 95% confidence interval 0.95 to 1.30) was found during an average of 8.8 years' follow-up. This study found no significantly increased risks of breast cancer overall (2578 v 2641.2; SIR 0.98, 0.94 to 1.01) or invasive breast cancer (2272 v 2371.4; SIR 0.96, 0.92 to 1.00). An increased risk of in situ breast cancer (291 v 253.5; SIR 1.15, 1.02 to 1.29; absolute excess risk (AER) 1.7 cases per 100 000 person years, 95% confidence interval 0.2 to 3.2) was detected, associated with an increasing number of treatment cycles (P=0.03). There was an increased risk of ovarian cancer (405 v 291.82; SIR 1.39, 1.26 to 1.53; AER 5.0 cases per 100 000 person years, 3.3 to 6.9), both invasive (264 v 188.1; SIR 1.40, 1.24 to 1.58; AER 3.4 cases per 100 000 person years, 2.0 to 4.9) and borderline (141 v 103.7; SIR 1.36, 1.15 to 1.60; AER 1.7 cases per 100 000 person years, 0.7 to 2.8). Increased risks of ovarian tumours were limited to women with endometriosis, low parity, or both. This study found no increased risk of any ovarian tumour in women treated because of only male factor or unexplained infertility. CONCLUSIONS: No increased risk of corpus uteri or invasive breast cancer was detected in women who had had assisted reproduction, but increased risks of in situ breast cancer and invasive and borderline ovarian tumours were found in this study. Our results suggest that ovarian tumour risks could be due to patient characteristics, rather than assisted reproduction itself, although both surveillance bias and the effect of treatment are also possibilities. Ongoing monitoring of this population is essential.
dc.formatElectronic
dc.format.extentk2644 - ?
dc.languageeng
dc.language.isoeng
dc.publisherBMJ PUBLISHING GROUP
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectHumans
dc.subjectBreast Neoplasms
dc.subjectOvarian Neoplasms
dc.subjectUterine Neoplasms
dc.subjectReproductive Techniques, Assisted
dc.subjectIncidence
dc.subjectRisk
dc.subjectCohort Studies
dc.subjectAdult
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectUnited Kingdom
dc.titleRisks of ovarian, breast, and corpus uteri cancer in women treated with assisted reproductive technology in Great Britain, 1991-2010: data linkage study including 2.2 million person years of observation.
dc.typeJournal Article
rioxxterms.versionofrecord10.1136/bmj.k2644
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2018-07-11
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfBMJ (Clinical research ed.)
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Breast Cancer Research
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Breast Cancer Research/Aetiological Epidemiology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Genetics and Epidemiology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Genetics and Epidemiology/Aetiological Epidemiology
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Breast Cancer Research
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Breast Cancer Research/Aetiological Epidemiology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Genetics and Epidemiology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Genetics and Epidemiology/Aetiological Epidemiology
pubs.publication-statusPublished
pubs.volume362
pubs.embargo.termsNot known
icr.researchteamAetiological Epidemiology
dc.contributor.icrauthorJones, Michael
dc.contributor.icrauthorSwerdlow, Anthony


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