How to Prevent, Diagnose, and Treat Gynecological Cancer in PCO Patients?

Abstract

The association between polycystic ovaries syndrome (PCOS) and endometrial cancer has been described in 1949 by Speert. Endometrial cancer is the most common gynecological cancer in North American and European women. There are several etiological and molecular mechanisms explaining the association between PCOS and endometrial cancer. Understanding them could lead to the establishment of possible means of prevention. The main hypothesis is that, in PCOS, there is an insufficient progesterone secretion due to a chronic anovulation leading to a prolonged endometrial exposure to unopposed estrogen. The latter promotes endometrial growth and cancerization. The perfect prevention for endometrial hyperplasia (EH) and endometrial cancer (EC) is not known, but combined oral contraceptive (COC) or progestin therapy are good ways to inhibit endometrial proliferation. The weight control is crucial in this pathology. Metformin has a place in prevention that has yet to be determined. The diagnosis of EH or EC can be made on the basis of the clinic (abnormal uterine bleeding (AUB)), transvaginal ultrasound, biopsy, and hysteroscopy. Concerning the risk of ovarian and breast cancer, no increased risk was found in women suffering from PCOS.