Evaluating the Association Between Endometrial Cancer and Polycystic Ovary Syndrome

Zeina Haoula; Maisa Salman; William Atiomo


Hum Reprod. 2012;27(5):1327-1331. 

In This Article

Materials and Methods

Studies Eligible for Review

Studies were eligible if they were retrospective or prospective, case–control cohort studies, cross-sectional or randomized controlled studies containing original data on association between PCOS and endometrial hyperplasia and carcinoma. Meta-analysis was performed on case–control cohort or cross-sectional studies.

Finding Relevant Studies

A literature search was carried out by two independent reviewers on major electronic databases: Medline 1996 to April 2011, EMBASE 1980 to April 2011and Cochrane Database of Systematic Reviews 1998 to April 2011. The keywords used to capture all potentially relevant studies were ' PCOS', 'PCO', 'polycystic ovary syndrome' or 'Stein–Leventhal syndrome' with 'endometrial carcinoma', 'EC' or 'endometrial hyperplasia'. Only articles published in English were retrieved. In addition, hand searching the abstracts of recent PCOS conferences and the references of all studies meeting the reference criteria were also carried out. All studies obtained as a result of the search were reviewed. The original PDFs of studies obtained from the search were located through direct online links to the files from the search results.

Data Abstraction

Data extraction was carried out independently by two investigators, Z.H. and M.S. Studies where the outcomes included the incidence or prevalence of EC and in women with PCOS were included. In order to evaluate the strength of the association between PCOS and endometrial cancer in these women, all the data relating to diagnosis, prevention and treatment were extracted for analysis.

Studies identified from the different databases were initially saved separately on Microsoft Excel 2007. These results were then merged and sorted to enable the identification and removal of duplicated search results. Full articles and abstracts derived as a result of the search were read, and original data were abstracted where available and summarized on a separate database.

Statistics and Data Analysis

A note was made of the total number of studies identified and excluded either due to duplication or following review of the abstracts. A meta-analysis was performed on the comparative studies and an OR established. Test of heterogeneity using I² value was used to measure the extent of inconsistency among results. The higher the value is, the bigger the heterogeneity is. The statistical test for overall effect size was defined using the probability (P) value. A funnel plot of comparison of studies was used to assess publication bias (Fig. 1).

Figure 1.

Funnel plot of comparison: 1 endometrial hyperplasia/cancer, outcome: 1.1 association between PCOS and endometrial hyperplasia/cancer.


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