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Aim  Polycystic ovary syndrome ( PCOS ) is a significant risk factor for premenopausal endometrial cancer ( EC ) and/or atypical endometrial hyperplasia ( AEH ). The aim was to elucidate the clinical background and detailed menstrual history of  EC  and/or  AEH  in young women with  PCOS .    Methods  From January 2001 to December 2013, women under 35 years of age who had been diagnosed with  EC  and/or  AEH  and who had been treated at Kumamoto University Hospital, Japan, were recruited. The patients’ clinical characteristics, clinical stages of  EC  and/or  AEH , medication and operation methods, endocrine profiles, and menstrual history were assessed retrospectively.    Results  Of all the cases of  EC  and/or  AEH , 25 (4.6%) were under 35 years of age. The mean age was 29.0 years and all the patients were nulligravida. The clinical stages of  EC  and/or  AEH  that were identified included:  AEH  (five cases), stage  IA  (18 cases),  IB  (one case), and  IIIA  (one case). Fourteen (56%) cases met the criteria for  PCOS . Both the Body Mass Index and Homeostatic Model Assessment–insulin resistance were significantly higher in the patients with  PCOS  than in the patients without  PCOS . Medroxyprogesterone acetate therapy was not effective for the patients with  PCOS  and they underwent a hysterectomy more often than the patients without  PCOS . All the patients with  PCOS  exhibited irregular menstruation or amenorrhea, the mean duration of which was 13.1 years before  PCOS  and  EC  and/or  AEH  were diagnosed.    Conclusion  Although both the patients with and without  PCOS  had irregular menstruation, the patients with  PCOS  were less likely to have fertility‐sparing surgery than the patients without  PCOS  because they had more advanced disease or failed to respond to medroxyprogesterone acetate therapy.

reproductive medicine and biology

Polycystic ovary syndrome: early diagnosis and intervention are necessary for fertility preservation in young women with endometrial cancer under 35 years of age