BACKGROUND: Primary multiplicity of malignant tumors of the female reproductive system is the least studied area of clinical oncology. In addition, the steady rise in the number of patients and various localizations of polyneoplasia with lesions of the female reproductive organs necessitate a detailed study of this problem. AIM: This study aimed to determine the incidence and risk factors and describe the clinical aspects of polyneoplasia of the female reproductive system for 20102021 in women seen at the Medical and Rehabilitation Center of the Ministry of Health of Russia, Moscow, and the University Clinical Hospital No. 4 of the I.M. Sechenov First Moscow State Medical University. MATERIALS AND METHODS: We conducted a retrospective analysis of the case records of 147 patients with a confirmed diagnosis of polyneoplasia of the female reproductive system for 20102021, which accounted for 3.6% of all newly diagnosed neoplasms of the female reproductive system in the above medical institutions. Moreover, a continuous sampling method was used. RESULTS: Breast cancer was the most frequent first tumor, combined with cancer of the contralateral breast in 27 (42.1%) patients, cancer of the uterine body in 4 (6.25%) patients, ovarian cancer in 4 (6.25%) patients, colon cancer in 4 (6.25%) patients, and thyroid cancer in 1 (1.5%) patient. Cancer of the uterine body was combined with breast cancer in 10 (35.7%) patients, ovarian cancer in 2 (7.1%) patients, thyroid cancer in 2 (7.1%) patients, and colon cancer in 3 (11.1%) patients. Endometrioid adenocarcinoma, pathogenic variant I was determined in 20 (71.4%) cases according to the histological structure. Thyroid cancer was detected in 7 (5.6%) cases; in all cases, it developed metachronously, and it was combined as the initial tumor with breast cancer in 1 (14.3%) case, uterine body cancer in 2 (28.5%) cases, and ovarian cancer in 1 (14.3%) case. As the second tumor, it was also combined with uterine body cancer in 2 (28.5%) cases and ovarian cancer in 1 (14.3%) case. The risk factors assessment led to the identification of several factors that are common in patients with hormone-dependent forms of primary multiple cancer, including obesity, diabetes mellitus, irregular menstrual cycle, history of proliferative diseases of the mammary glands, intake of thyroid drugs, uterine hyperplastic processes, and hypothyroidism. CONCLUSIONS: Understanding the different aspects of the development and course of hormone-dependent polyneoplasia of the female reproductive system will help in developing approaches for follow-up monitoring of women who have been treated for a primary tumor and are at risk of developing a subsequent tumor of hormone-dependent organs, to prevent the recurrence of the disease and predict the subsequent tumor and ensure its timely detection.

BACKGROUND: The problem of infertility has not only medical, but also socio-demographic significance. To date, the global scale of the spread of various forms of infertility is beyond doubt among specialists around the world. This, in turn, causes an increase in the frequency of prescribing assisted reproductive technologies, but the question of the relationship between the prescribing of drugs used to treat infertility and the risk of developing cancer of the uterine body remains poorly understood. AIM: The aim of this study was to assess the possible relationship between in vitro fertilization, the use of ovulation stimulation drugs and the risk of developing uterine cancer in women with infertility. MATERIALS AND METHODS: This literature systematic review is based on resources from the following databases: Medline, ClinicalKey, Google Scholar, Embase, the Cochrane Library, and eLIBRARY for the period 19992022. The search for publications was carried out using keywords defined in accordance with the PICO principle (P, population or patients; I, intervention; C, comparison; O, outcomes): female, women, infertility, infertility treatment, in vitro fertilization, IVF, assisted reproductive technology, ART, ovarian stimulation, ovarian hyperstimulation, clomiphene citrate, hCG, hMG, tamoxifen, uterine, endometrial, cancer, carcinoma neoplasm, uterine neoplasm. The following SQL operators were used during the search: AND and OR. RESULTS: The search resulted in 37 representative publications, with eight studies selected for meta-analysis. CONCLUSIONS: This systematic review and meta-analysis have demonstrated the ambiguity of the design and results of studies on the possible relationship of uterine cancer and assisted reproductive technology methods published to date. The issue under review is urgent due to the high frequency of infertility and an increase in the frequency of gynecologic cancers. The conducted studies confirm that it is impossible to evaluate the carcinogenic effect of ovulation inducers or in vitro fertilization methods without adjusting for the infertility factor, as well as risk factors for uterine cancer. There is still a high need for further research, particularly for studying the safety profile of infertility treatment methods in relation to long-term cancer risks.

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Mutations of the BRCA1/2 genes constitute a fundamental and independent risk factor in the genesis of both breast cancer and ovarian cancer. The specifics of the infertility treatment effect on the risk of developing cancer in carriers of mutations in the BRCA1/2 genes remain unclear and require a comprehensive investigation. In this review, we analyzed published sources on the possible relationship between the infertility treatment and the risk of ovarian and breast cancer in BRCA1/2 mutation carriers.

BACKGROUND: Cervical cancer is one of the leading cancers in women of reproductive age. The etiological role of the human papillomavirus (HPV) in cancer development is long known and undisputed. However, owing to the widespread use of combined oral contraceptives (COCs), scientists actively investigate possible mechanisms of interrelation between sex steroids and HPV in terms of cervical cancer risk. AIM: This study aimed to assess the risk of cervical cancer in women of reproductive age, depending on the use of COCs for different durations. MATERIALS AND METHODS: The study included 411 patients of reproductive age who were treated at the Center for Gynecology and Reproductive Technologies of the Russian Ministry of Health and the Department of Oncogynecology at the University Clinical Hospital No. 4 of the I.M. Sechenov First Moscow State Medical University between January 2015 and December 2021. All patients were divided into two groups. The study group included 291 patients with verified cervical cancer, and the control group included 120 patients without cancer. RESULTS: The study group was significantly more likely to take COCs (56, or 19.2%) than the control group (11, or 6.5%; p=0.018). In addition, the study group had significantly longer treatment durations (p=0.011). Overweight (n = 52, or 17.9%) and grade II obesity (n = 11, or 3.8%, vs. 0; p=0.03) were significantly more common in the study group than in the control group (n = 8, or 4.7%; p=0.003). The result of the multivariate analysis showed that taking COCs negatively affect cervical cancer development (p=0.018; odds ratio (OR) 1.230; CI 1.0641.423). The receiver operating characteristic analysis revealed that the use of COCs has a high predictive value for determining the risk of cervical cancer (area under the curve, AUC=0.742); the sensitivity and specificity of this predictor were 74.07% and 72.73%, respectively. In the assessment on the effect of duration of COC use on the risk of cervical cancer, the results showed that total use of COCs for over 7 years was associated with a higher risk of cervical cancer development (p=0.010; OR 1.68; CI 1.12.5). CONCLUSIONS: Prescribing COCs in patients with HPV infection requires a personalized approach to consider etiologic factors of cervical cancer and reduce possible carcinogenic risks.