PCOS increases risk of pancreatic cancer

By Suchandrima BhowmikReviewed by Benedette Cuffari, M.Sc.Dec 21 2022

A new study in the journal JAMA Oncology confirms that a history of polycystic ovarian syndrome (PCOS) increases a patient’s risk of developing pancreatic cancer.

Study: Association Between Polycystic Ovary Syndrome and Risk of Pancreatic Cancer. Image Credit: Alena Menshikova / Shutterstock.com

Risk factors for pancreatic cancer

The rate of pancreatic cancer throughout the world has increased over the past several years, accounting for about 2% of all cancer diagnoses and 5% of all cancer-related deaths. Pancreatic cancer is a highly invasive disease associated with a high mortality rate, with only about 11% of pancreatic cancer patients estimated to survive five years after their initial diagnosis.

The early diagnosis of pancreatic cancer is essential; however, due to the lack of apparent symptoms caused by this disease, it remains challenging to diagnose through conventional screening approaches. Thus, understanding the risk factors for pancreatic cancer can help to improve clinical vigilance, increase education, and ultimately support the early diagnosis of this disease.

Several factors have been shown to increase an individual’s risk of pancreatic cancer. Since over 90% of new pancreatic cancer diagnoses are among patients aged 55 years or older, age can also be considered a risk factor for this disease. Furthermore, pancreatic cancer affects men more than women worldwide, with this gender gap more pronounced in developed countries.

Several pre-existing health conditions may also increase a patient’s risk of pancreatic cancer, including diabetes, chronic pancreatitis, and obesity. Furthermore, the abnormal metabolism of human microorganisms, an individual’s blood type, and their glucose and lipid levels may also contribute to their risk of developing pancreatic cancer.

PCOS, a common endocrine condition associated with numerous carcinogenic processes, has previously been associated with an increased risk of developing pancreatic cancer. In fact, one 2019 study reported that women with PCOS were associated with a 3.4-fold higher risk of pancreatic cancer; however, only five women with PCOS who had pancreatic cancer were included in this study.

About the study

The current study involved female participants, 21 years or older, and English speaking who were enrolled in the Memorial Sloan Kettering Cancer Center Pancreatic Tumor Registry. The study was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidelines.

The 446 cases that met these criteria were diagnosed with pancreatic adenocarcinoma by pathological or cytological analysis. Additionally, 209 control patients with no personal history of pancreatic cancer who accompanied patients to clinics were included in the final analysis.

All study participants were asked, “Have you ever had polycystic ovaries?” Those who confirmed a previous diagnosis of polycystic ovaries provided their age at that diagnosis and any treatment they received for this condition. This information was then used to estimate odds ratios (ORs) and 95% confidence intervals (Cis) for the association between PCOS and the risk of developing pancreatic cancer.

Information on demographics, education, smoking status, body mass index (BMI), diabetes, and estrogen use was also collected from all the participants.

Increased risk of pancreatic cancer

PCOS was found to be associated with a 1.9-fold higher risk of pancreatic cancer after adjusting for estrogen use, BMI, ethnicity, and age. Notably, this positive association was slightly reduced for participants with type 2 diabetes. A history of familial pancreatic cancer did not impact the final association between PCOS and pancreatic cancer.

The current study, which is the second of its kind to examine the relationship between PCOS and the risk of pancreatic cancer, confirms a strong association between these two diseases. Thus, a prior PCOS diagnosis can be used by clinicians to increase their vigilance for potential pancreatic cancer patients, as well as provide specialized education to these at-risk patients.

Despite these observations, further research is needed to better understand the underlying biological mechanisms that may contribute to this association. Furthermore, more extensive retrospective studies may provide additional insights into the risk of developing pancreatic cancer in PCOS patients.