PMOS Linked to Increased Risk of Reproductive Cancers

POLYENDOCRINE metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), is associated with an increased risk of several female reproductive cancers, according to a large US study involving more than 2.5 million reproductive-age women.

Women with PMOS had a significantly higher risk of breast, uterine, ovarian/fallopian tube, and cervical cancers compared with women without the condition, even after researchers accounted for a range of clinical and demographic factors.

More Than 400,000 Women With PMOS Studied

PMOS is associated with hormonal and metabolic abnormalities, including irregular ovulation, obesity, and diabetes. While its association with uterine cancer is well recognised, evidence surrounding other reproductive cancers has previously been inconsistent.

Researchers therefore conducted a retrospective cohort study using the Optum Clinformatics Data Mart database from 2000–2022.

The analysis included 422,613 women aged 18–50 years with PMOS, who were age-matched with 2,113,065 women without PMOS. Mean age was 31.3 years in both groups, with an average follow-up of approximately 3.6 years.

Analyses accounted for factors including obesity, diabetes, hypertension, smoking, infertility, race and ethnicity, education, hereditary cancer syndromes, and hormonal contraceptive use.

Uterine Cancer Risk Nearly Six-Times Higher

The largest association was observed for uterine cancer. After adjustment, women with PMOS had 5.76-times the hazard of uterine cancer compared with those without PMOS.

PMOS was also associated with 4.38-times the hazard of ovarian or fallopian tube cancer and 2.66-times the hazard of breast cancer.

Notably, researchers also identified an association with cervical cancer, with women with PMOS experiencing 2.22-times the adjusted hazard. The authors report that theirs is the first study to suggest an increased hazard of cervical cancer among women with PMOS.
Sensitivity analyses accounting for medications including metformin, antihypertensives, and statins produced similar findings.

Could PMOS Care Incorporate Cancer Risk?

Current PMOS guidance focuses predominantly on the established association with endometrial hyperplasia and uterine cancer. However, the researchers suggest their findings could support broader consideration of cancer risk during PMOS care.

The observational nature of the study means it cannot establish that PMOS directly causes these cancers. Claims data also lacked information including BMI, complete reproductive history, and family history of reproductive cancers, while the relatively short mean follow-up could limit detection of cancers developing later in life.

Nevertheless, the authors conclude that the findings highlight the need for greater clinical awareness and further research to determine whether cancer-related counselling or screening recommendations should be incorporated into routine PMOS care.

Reference

Alur-Gupta S et al. Polycystic ovary syndrome and the risk of female reproductive cancers. Fertil Steril. 2026. doi:10.1016/j.fertnstert.2026.05.158.

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