Previous cancers in women diagnosed with premature ovarian insufficiency: A nationwide population‐based case–control study

• Published in: Acta obstetricia et gynecologica Scandinavica Vol. 103; no. 5; pp. 842 - 849
• Main Authors: Silvén, Heidi, Savukoski, Susanna M., Pesonen, Paula, Niinimäki, Riitta, Pukkala, Eero, Gissler, Mika, Suvanto, Eila, Niinimäki, Maarit
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.05.2024; John Wiley and Sons Inc; Wiley
• Subjects: Adult; cancer; cancer survivor; Cancer therapies; Case-Control Studies; early menopause; Endocrinology; Female; Finland - epidemiology; Hormone replacement therapy; Humans; Information systems; Medical diagnosis; Menopause, Premature; Neoplasms; Original; Ovaries; premature ovarian insufficiency; Primary Ovarian Insufficiency - epidemiology; Survivor; young adult cancer; Young adults; Finland; cancer; premature ovarian insufficiency; early menopause; young adult cancer; cancer survivor
• ISSN: 0001-6349; 1600-0412; 1600-0412
• DOI: 10.1111/aogs.14783

Introduction To investigate the occurrence of previous cancer diagnoses in women suffering from premature ovarian insufficiency (POI) and compare it with the general population, shedding light on the association between cancer, cancer treatments, and POI. Material and methods We conducted a nationwide case–control study based on registry data from various sources, including the Social Insurance Institution, Finnish Population Information System, and Finnish Cancer Registry spanning from 1953 to 2018. Our participants comprised all women in Finland who, between 1988 and 2017, received hormone replacement therapy reimbursement for ovarian insufficiency before the age of 40 years (n = 5221). Controls, matched in terms of age and municipality of residence, were selected from the Finnish Population Information System (n = 20 822). Our main exposure variable was a history of cancer diagnosis preceding the diagnosis of POI. We analyzed odds ratios (OR) to compare the prevalence of previous cancers in women with POI with that in controls, stratifying results based on cancer type, age at cancer diagnosis, and the time interval between cancer diagnosis and POI. We also assessed changes in OR for previous cancer diagnoses over the follow‐up period. Results Out of the women diagnosed with POI, 21.9% had previously been diagnosed with cancer, resulting in an elevated OR of 36.5 (95% confidence interval [CI] 30.9 to 43.3) compared with 0.8% of the controls. The risk of developing POI was most pronounced during the first 2 years following a cancer diagnosis, with an OR of 103 (95% CI 74.1 to 144). Importantly, this risk remained elevated even when the time interval between cancer and POI exceeded 10 years, with an OR of 5.40 (95% CI 3.54 to 8.23). Conclusions This study reveals that 21.9% of women with POI have a history of cancer, making the prevalence of cancer among these women 27.5 times higher than age‐matched controls in the Finnish population. The risk of developing POI is most substantial in the first 2 years following a cancer diagnosis. These findings underscore the role of cancer treatments as an etiological factor for POI and emphasize the importance of recognizing the risk of POI in cancer survivors for early diagnosis and intervention. This study investigated the prevalence of previous cancer diagnoses in women with premature ovarian insufficiency (POI) compared with the general population, using a nationwide case–control study based on registry data spanning from 1953 to 2018. Among women diagnosed with POI, 21.9% had a history of cancer, resulting in a significantly elevated odds ratio (OR) of 36.5 (95% confidence interval [CI] 30.9 to 43.3) compared with controls. Notably, the risk of developing POI was most pronounced within the first 2 years following a cancer diagnosis, with an OR of 103 (95% CI 74.1 to 144), highlighting the impact of cancer treatments on the etiology of POI. These findings underscore the importance of recognizing the heightened risk of POI in cancer survivors for early diagnosis and intervention.