Evidence map›Paper›PMID 42440318›Full record

ArticleJAMA network open2026

Medically Assisted Reproduction and Hormone-Related Cancers.

Adrian Raymond Walker, Christos Venetis, Signe Opdahl, Antoinette C Anazodo, Neville F Hacker, Michael Chapman, Louisa Jorm, Robert J Norman, Catharyn Stern, Ursula M Sansom-Daly and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Adrian Raymond WalkerCentre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
Christos VenetisCentre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
Signe OpdahlCentre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
Antoinette C AnazodoKids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.
Neville F HackerWomen's Health, Paediatrics & Child Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
Michael ChapmanSt George Hospital, School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
Louisa JormCentre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
Robert J NormanRobinson Research Institute, Faculty of Health and Medical Sciences, Adelaide University, Adelaide, Australia.
Catharyn SternMelbourne IVF Melbourne, Australia.
Ursula M Sansom-DalyKids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.
Georgina Mary ChambersCentre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
Claire Melissa VajdicKirby Institute, University of New South Wales, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: It is critical that women undertaking medically assisted reproductive (MAR) treatment and their clinicians know whether the treatments are associated with an increased risk of hormone-related cancers. Objective: To determine the risk of hormone-related cancers following MAR treatment. Design, Setting, and Participants: This cohort study used an emulated target trial design including Australian health registries and administrative datasets. Participants included women enrolled in Medicare, Australia's universal health insurance scheme, aged 18 to 55 years between January 1, 1991, and December 31, 2018. Data were analyzed from April 2024 to July 2025. Exposures: Exposures were defined from Medicare records: assisted reproduction therapy, intrauterine insemination or ovarian stimulation, and ovulation induction with clomiphene citrate. Main Outcomes and Measures: Hormone-related invasive cancers (identified in the Australian Cancer Database) included breast, ovarian, uterine, thyroid, colorectal cancers and melanoma; in situ cancers included breast cancer and melanoma. Three cancers with no hormonal links-pancreatic, lung, and hematological-were included as negative controls. Flexible parametric survival models ascertained hazard ratios (HRs) and cumulative marginal survival differences in incident cancers per 100 000 population. E-values assessed the risk of bias due to unmeasured confounding. Results: A total of 1 748 927 women were identified, including 396 661 with history of MAR exposure. Although elevated risk of most hormone-related cancers was observed after MAR treatment (HRs, 1.09-1.64), E-value analysis suggested confounding due to underlying infertility conditions (ie, endometriosis, polycystic ovarian syndrome) could account for this observed elevation for uterine, ovarian, and thyroid cancers. For any specific invasive cancer, fewer than 20 extra cancers per 100 000 women each year were estimated for treated vs comparator groups. Emulated trials on the 6 hormone-related cancers and pancreatic and hematological cancers showed increased cancer risk in the first years after treatment, suggesting detection bias. Increased risk of hematological cancers was observed after MAR treatment (HRs, 1.18-1.27), indicating uncontrolled confounding by race and ethnicity may account for observed excess risk seen for several cancers. Some treatments were associated with decreased lung cancer risk (HRs, 0.72-0.82). Conclusions and Relevance: In this cohort study of MAR and cancer using a target trial emulation design, although associations between MAR and some hormone-related cancers were observed, the estimated difference in the number of expected cancers was small and may be explained by unmeasured confounding and detection bias.

Indexed as

NeoplasmsReproductive Techniques, AssistedAdolescentAdultAustraliaBreast NeoplasmsCohort StudiesFemaleHumansMiddle AgedOvarian NeoplasmsOvulation InductionYoung Adult

Identifiers

PMID42440318
PMCPMC13366193

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.