Cancer Risk Profiles in PCOS: A Comparative Analysis Between Reproductive-Aged and Post-Reproductive-Aged Women [ID 987]

INTRODUCTION: Polycystic ovary syndrome (PCOS), affecting 11–13% of women globally, is associated with multiple health complications, including increased risk of endometrial cancer. However, the risks for breast and ovarian cancers remain unclear. This study evaluates the cancer risk profiles in women with PCOS, comparing those of reproductive age (RA; 15–44 years) with post-reproductive age (P-RA; 45 years and older). METHODS: We conducted a retrospective analysis using the TriNetX database of deidentified medical records on June 30, 2024. Cohorts of women with and without PCOS were stratified by age to assess PCOS effect on endometrial, breast, and ovarian cancer risks. Propensity matching was used to account for confounders: age/race/ethnicity. A value of P ≤.05 was deemed significant. RESULTS: Among women with PCOS (n=98,239), there was a significantly higher relative risk (RR) of endometrial cancer (RR 2.39) and significantly lower RR of breast cancer (RR 0.85), compared to women without PCOS (n=98,239), and no significant difference in ovarian cancer risk. P-RA women with PCOS had a significantly higher RR of endometrial, breast, and ovarian cancers compared to RA women with PCOS (RA [n=37,988] versus P-RA [n=37,988]: endometrial RR 0.424; ovarian RR 0.263; breast RR 0.174). CONCLUSIONS/IMPLICATIONS: This study confirms the reported increased risk of endometrial cancer in women with PCOS and demonstrates a higher risk for all three cancer types in P-RA women with PCOS. The findings support enhanced cancer screening for women with PCOS, particularly those who are post-reproductive age. Further research is needed to understand the hormonal influences on cancer risk in this population.