Early Menopause and Primary Ovarian Insufficiency Linked to Greater Cancer Risk

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Study results may change the understanding and treatment of hormone-based treatment of primary ovarian insufficiency based on genetics.

© Sebastian Kaulitzki - stock.adobe.com

breast cancer © Sebastian Kaulitzki - stock.adobe.com

Women who experience early menopause or have primary ovarian insufficiency (POI) are about two times more likely to develop breast cancer and nearly four times more likely to develop ovarian cancer, according to research presented last week at the Endocrine Society’s annual meeting in Boston, Mass. The full research is not yet published.

Primary ovarian insufficiency, previously called premature ovarian failure, is a rare condition where women stop having their periods before the age of 40. It affects approximately 1% of women and is commonly treated with hormone replacement therapy. It is not the same thing as early menopause, because unlike early menopause, women with POI can spontaneously begin their periods again. Early menopause is characterized by later menstruation cessation between the ages 40 to 45, which is permanent, according to the Cleveland Clinic.

A research team led by Corrine Welt, M.D., chief of the Division of Endocrinology, Metabolism and Diabetes at the University of Utah Health, identified 613 women with POI and 165 with early menopause using databases from two health systems in Utah which serve 85% of the state’s population. The medical records studied were from the years 1995-2021.

They then used Utah Population Database genealogy information to find the relatives of these women to check their relative’s cancer history, searching specifically for breast, ovarian, colon and prostate cancers.

Of these women, 416 with POI had at least three generations of genealogical data. This included 2,405 first-degree relatives, 6,798 second-degree relatives and 17,666 third-degree relatives.

When researchers reviewed the data, they found women with POI were 1.89 times more likely to get breast cancer. When women with early menopause were added, the breast cancer risk remained the same but ovarian cancer risk became 3.38.

Among second-degree relatives such as aunts, nieces and grandparents, breast cancer risk was increased by 1.3 times and colon cancer was increased 1.5 times.

Prostate cancer risk was 1.3 times in first, second and third generations.

“Clinicians need tools to predict cancer risk and comorbid disease in women with POI and early menopause to adequately counsel about future health risk,” Welt wrote in the abstract sent to Managed Healthcare Executive. “This understanding may change recommendations for hormone replacement based on the underlying genetic cause of POI for an individual.”

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