ArticleJournal of the National Cancer Institute2021
Long-Term Risk of Ovarian Cancer and Borderline Tumors After Assisted Reproductive Technology.
Article in Journal of the National Cancer Institute, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Association between ovarian tumors and exposure to assisted reproductive technologies and ovarian stimulation: a systematic review and meta-analysis.Archives of gynecology and obstetrics · 2024Pooled it
- Ovulation induction drug and ovarian cancer: an updated systematic review and meta-analysis.Journal of ovarian research · 2023Pooled it
- Assisted Reproductive Technology in Breast and Gynecologic Malignancies: Cancer Risk, Fertility Preservation, and Post-Treatment Reproductive Outcomes.Journal of clinical medicine · 2026Review
- Comparison of Frozen Section and Final Pathology Results in Borderline Ovarian Tumors: A Retrospective Cohort Study.Diagnostics (Basel, Switzerland) · 2026Article
- Medically Assisted Reproduction and Hormone-Related Cancers.JAMA network open · 2026Article
- Controlled Ovarian Stimulation After Fertility-Sparing Surgery for Borderline Ovarian Tumors: An Exploratory Cohort Study on Recurrence and Reproductive Outcomes.Current oncology (Toronto, Ont.) · 2026Article
- Analysis of ovarian cancer burden among reproductive-aged women and its association with the socio-demographic index from 1990 to 2021.World journal of surgical oncology · 2026Article
- Cancer Incidence in Women After Medically Assisted Reproduction.JAMA network open · 2026Article
- Fertility treatment and risk of non-Hodgkin lymphoma - results from a Danish population-based cohort study.Cancer causes & control : CCC · 2025Article
- Effects of Infertility Drug Exposure on the Risk of Borderline Ovarian Tumors: A Systematic Review and Meta-Analysis.Biomedicines · 2023Review
- Risk of ovarian cancer in women who give birth after assisted reproductive technology (ART)-a registry-based Nordic cohort study with follow-up from first pregnancy.British journal of cancer · 2023Article
- The challenging management of borderline ovarian tumors (BOTs) in women of childbearing age.Frontiers in surgery · 2022Review
- Reproductive issues in carriers of germline pathogenic variants in the BRCA1/2 genes: an expert meeting.BMC medicine · 2021Article
Corrections and comments
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Authors and funding
24 authors at 14 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLong-term effects of assisted reproductive technology (ART) on ovarian tumor risk are unknown.
methodsThis nationwide cohort study comprises 30 625 women who received ovarian stimulation for ART in 1983-2000 and 9988 subfertile women not treated with ART. Incident invasive and borderline ovarian tumors were ascertained through linkage with the Netherlands Cancer Registry and the Dutch Pathology Registry until July 2018. Ovarian tumor risk in ART-treated women was compared with risks in the general population and the subfertile non-ART group. Statistical tests were 2-sided.
resultsAfter a median follow-up of 24 years, 158 invasive and 100 borderline ovarian tumors were observed. Ovarian cancer risk in the ART group was increased compared with the general population (standardized incidence ratio [SIR] = 1.43, 95% confidence interval [CI] = 1.18 to 1.71) but not when compared with the non-ART group (age- and parity-adjusted hazard ratio [HR] = 1.02, 95% CI = 0.70 to 1.50). Risk decreased with higher parity and with a larger number of successful ART cycles (resulting in childbirth, Ptrend = .001) but was not associated with the number of unsuccessful ART cycles. Borderline ovarian tumor risk was increased in ART-treated women compared with the general population (SIR = 2.20, 95% CI = 1.66 to 2.86) and with non-ART women (HR = 1.84, 95% CI = 1.08 to 3.14). Risk did not increase with more ART cycles or longer follow-up time.
conclusionsIncreased ovarian cancer risk in ART-treated women compared with the general population is likely explained by nulliparity rather than ART treatment. The increased risk of borderline ovarian tumors after ART must be interpreted with caution because no dose-response relationship was observed.
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