Prenatal Biochemical Screening and a Woman's Long-Term Risk of Cancer: A Population-Based Cohort Study

Area of Science:

• Reproductive Endocrinology
• Oncology
• Prenatal Diagnostics

Background:

• Hormones measured during pregnancy are associated with hormone-sensitive cancers.
• Investigating the link between prenatal screening markers and subsequent cancer risk is crucial for early detection and prevention strategies.

Purpose of the Study:

• To determine if routine serum screening during pregnancy is associated with a woman's future risk of developing hormone-sensitive cancers.
• To analyze the association between specific prenatal screening hormone levels and the incidence of breast, ovarian, endometrial, and thyroid cancers.

Main Methods:

• Population-based cohort study of women aged 12-55 undergoing prenatal screening in Ontario, Canada (1993-2011).
• Estimated hazard ratios for cancer diagnosis post-gestation based on extreme percentiles (≤5th or >95th MoM) of AFP, hCG, unconjugated estriol, PAPP-A, and dimeric inhibin A.
• Multivariable adjusted models were used to account for confounding factors.

Main Results:

• Over 677,000 pregnancies were followed for a median of 11 years, with 7,231 breast, 515 ovarian, 508 endometrial, and 4,105 thyroid cancer diagnoses.
• Abnormally high hCG (>95th percentile MoM) was associated with a doubled risk of endometrial cancer (aHR=1.98).
• Abnormally low AFP (≤5th percentile MoM) was linked to a moderately increased risk of thyroid cancer (aHR=1.21).

Conclusions:

• Elevated hCG or reduced AFP levels in early pregnancy may indicate a higher future risk for specific hormone-sensitive cancers.
• These findings highlight the potential of prenatal screening markers as early indicators for long-term cancer risk assessment.