医疗辅助生殖后妇女癌症发生率
Claire Melissa Vajdic1, Adrian Raymond Walker2, Antoinette C Anazodo3,4
1Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
JAMA network open
|March 10, 2026
概括
使用医疗辅助生殖 (MAR) 的女性的癌症发病率与一般人群相似. 虽然一些特定的癌症的发病率略有增加,但MAR用户的整体癌症风险仍然相当.
科学领域:
- 生殖健康 生殖健康
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 医疗辅助生殖 (MAR) 涵盖了各种生育治疗.
- 需要对使用MAR的女性癌症发生的高质量证据.
- 之前的研究已经产生了不一致的结论,关于MAR后癌症风险.
研究的目的:
- 为了将暴露于MAR的女性的癌症发病率与一般人口进行比较.
- 为了研究不同MAR治疗类型的癌症风险:辅助生殖疗法 (ART),卵巢刺激的子宫内授精 (IUI/OS) 和克洛米芬酸盐的排卵诱导.
主要方法:
- 澳大利亚18-55岁妇女的基于人口的队列研究,她们在1991-2018年间使用了MAR.
- 管理卫生数据集和登记册的链接,以确定MAR治疗,怀孕,癌症和死亡.
- 使用标准化发病率 (SIR) 和率差异,将MAR暴露的女性与年龄,司法管辖区和日历年相匹配的一般人口进行比较.
主要成果:
- 整体侵入性癌症发病率与ART (SIR: 1.00) 和IUI/OS (SIR: 0.99) 队列的一般人群相比,对于克洛米芬酸盐 (SIR: 1.04) 略高.
- 对于子宫癌 (SIRs: 1.23-1.83),黑色素瘤 (SIRs: 1.07-1.15) 卵巢癌 (ART/IUI/OS队列) 和现场乳腺癌 (ART队列) 观察到的发病率增加.
- 宫癌 (SIR:0.52-0.61) 和肺癌 (SIR:0.62-0.70) 的发病率较低. 高度癌症的多余病例很小.
结论:
- 使用MAR的女性的整体癌症发病率与一般人群相比较.
- 虽然特定的癌症类型显示轻微的升高,绝对的过剩是小的,而其他癌症类型显示发生率降低.
- 调查结果为妇女和医疗保健提供者提供了有价值的信息,但没有推断因果关系.
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