Studies have found that individuals with PCOS are at 2.5-4.1x the risk for developing ovarian cancer relative to individuals without PCOS.[1],[2]  Another study concluded that women with PCOS were at a 2x increased risk for ovarian cancer, but only after menopause.[3]

In this article we explore the link between PCOS and ovarian cancer.

PCOS is associated with elevated levels of androgens[4], sex hormones that are produced in the ovaries, start at puberty and play a key role in reproductive health.[5]  Find out more about PCOS and Androgen Excess.

• High androgen levels lead to an increase in androgen receptor activation,[6] the process by which androgens bind to granulosa and theca cells within the ovary;[7]

• Increased androgen receptor activity leads to an increase in transcription and translocation of ovarian cancer cells,[8] the processes by which cells make an RNA copy of a piece of DNA[9] and by which a piece of one chromosome breaks off and attaches to another chromosome[10] and therefore leads to growth in ovarian cancer cells;

• Increased mutation and proliferation of cancer cells has a compounding affect as it results in higher activity of nuclear receptor coactivator 3 (NCOA3) and androgen receptor-associated protein 70 (ARA70),[11] proteins that amplify the impact of androgen receptors by up to 10x;[12] and

• These effects lead to an increased risk of cancer in the lining of the ovary (epithelial ovarian cancer or adenocarcinoma)[13],[14],[15], representing 90% of all ovarian cancers[16] with androgens implicated in 70-95% of this type of cancers.[17]

In addition, individuals with PCOS are more likely to use assisted reproductive technology (ART), particularly ovulation induction, which is also known to increase the risk of ovarian cancer (although the mechanism is unknown).[18]

Risk factors for ovarian cancer include:[19]

• Increasing age;

• Inherited genetic variants including BRCA1 and BRCA2, genetic variants also linked with increased breast cancer risk, genetic changes associated with Lynch syndrome and changes to genes BRIP1, RAD51C and RAD51D;

• Family history of ovarian cancers;

• Obesity;

• Postmenopausal hormone replacement therapy (HRT);

• Endometriosis;

• Early onset of menstruation and / or late onset of menopause; and

• Never having been pregnant.

Reviewed by Dr. O, one of Neuraura’s friends and trusted advisors.

Sources

[1] https://www.sciencedirect.com/science/article/abs/pii/0029784496002268

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2683463/

[3] https://ecancer.org/en/news/23282-cancer-risk-among-women-with-polycystic-ovary-syndrome-doubles-after-menopause

[4] https://www.uptodate.com/contents/polycystic-ovary-syndrome-pcos-beyond-the-basics/

[5] https://my.clevelandclinic.org/health/articles/22002-androgens

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406955/

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937455/

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406955/

[9] https://www.cancer.gov/publications/dictionaries/cancer-terms/def/transcription

[10] https://www.cancer.gov/publications/dictionaries/cancer-terms/def/translocation

[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406955/

[12] https://pubmed.ncbi.nlm.nih.gov/11161850/

[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406955/

[14] https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq

[15] https://www.cancer.gov/ccg/research/genome-sequencing/tcga/studied-cancers/ovarian-serous-adenocarcinoma

[16] https://www.cancer.gov/ccg/research/genome-sequencing/tcga/studied-cancers/ovarian-serous-adenocarcinoma#

[17] https://pubmed.ncbi.nlm.nih.gov/11161850/

[18] https://pubmed.ncbi.nlm.nih.gov/23624028/

[19] https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/symptoms-causes/syc-20375941