Nándor Ács

Association of oral contraceptives and risk of endometrial cancer: A systematic review and meta‐analysis

AbstractIntroductionAlthough the relationship between the use of oral contraceptives and reduced endometrial cancer risk has now long been established, the need for female patients to be informed on this matter based on the latest results of scientific research remains. To help the evidence‐based decision‐making of women when choosing contraception methods, we aimed to provide them with an up‐to‐date overview and summary of past and recent findings on the association between the use of oral contraceptives and endometrial cancer risk.Material and MethodsThis study was registered in PROSPERO: CRD42022379871. PubMed, Embase, and Cochrane Library databases were searched on the December 5, 2022, to identify eligible articles. We included all experimental and observational studies that reported the number of users and non‐users of oral contraceptives among patients diagnosed or not with endometrial cancer. Data were extracted, and random‐effects meta‐analysis was performed to obtain summary odds ratios (OR) with 95% confidence intervals (CI). Heterogeneity across studies was assessed using Higgins & Thompson's I2 statistic.ResultsFifty‐six studies were eligible for qualitative synthesis, of which twenty‐five were eligible for quantitative analysis. The use of oral contraceptives was inversely associated with the odds of having endometrial cancer (OR = 0.61, CI: 0.46–0.80). The long‐term use of oral contraceptives led to the greatest odds reduction in having endometrial cancer (≥10 years: OR = 0.31, CI: 0.13–0.70), while shorter periods were also associated with a significant decrease in these odds, although to a lesser extent (≥5 years: OR = 0.39, CI: 0.23–0.64; <5 years: OR = 0.66, CI: 0.48–0.91).ConclusionsThe administration of oral contraceptives is time dependently associated with lower odds of having endometrial cancer, suggesting a protective association between the use of oral contraceptives and endometrial cancer.

The Possible Role of Mycotoxins in the Pathogenesis of Endometrial Cancer

Endometrial cancer is one of the most common cancer types among women. Many factors can contribute to the development of this disease, including environmental factors and, thus, eating habits. Our study aims to determine the levels of various mycotoxins and their metabolites in the blood serum and endometrial tissue samples of participants with previously proven endometrial cancer and to find possible contributions to cancer development. In the cohort clinical trial, 52 participants aged between 44 and 86 were studied. The participants were divided into two groups: patients or matched controls. All patients had previously histologically diagnosed endometrial cancer. The cancer patients were divided into low-grade endometrioid and low- plus high-grade endometrioid groups. Controls had no history of endometrial malignancy or premalignancy. Blood serum and endometrial tissue samples were obtained from all study patients. We compared the concentrations of total Aflatoxins (Afs), Deoxynivalenol (DON), Ochratoxin-A (OTA), T2-toxin and HT2 toxin (T2/HT2 toxin), Zearalenone (ZEN), alpha-Zearalenol (α-ZOL), and Fumonisin B1 (FB1) in the serum and endometrium between the different study groups. As a result, we can see a significant correlation between the higher levels of Afs and zearalenone and the presence of endometrial cancer. In the case of Afs, DON, OTA, T2/HT2 toxins, ZEN, and alpha-ZOL, we measured higher endometrial concentrations than in serum. Considering the effect of mycotoxins and eating habits on cancer development, our results might lead to further research exploring the relationship between certain mycotoxins and endometrium cancer.