Melanoma, thyroid, cervical, and colon cancer risk after use of fertility drugs

Objective This study was undertaken to evaluate melanoma, thyroid, colon, and cervical cancer risks after clomiphene or gonadotropins. Study design Retrospective cohort of 8422 women (155,527 women-years) evaluated for infertility (1965-1988). Through 1999, cancers were ascertained by questionnaire, cancer and death registries. Poisson regression estimated adjusted rate ratios (RRs). Results Clomiphene use did not significantly increase risk of melanoma (RR = 1.66; 95% CI, 0.9-3.1), thyroid (RR = 1.42; 95% CI, 0.5-3.7), cervical (RR = 1.61; 95% CI, 0.5-4.7), or colon cancer (RR = 0.83; 95% CI, 0.4-1.9). We found no relationship between clomiphene dose or cycles of use and cancer risk at any site. Clomiphene use may impart stronger effects on risks of melanoma (RR = 2.00; 95% CI, 0.9-4.6) and thyroid cancer among women who remained nulliparous (RR = 4.23; 95% CI, 1.0-17.1). Gonadotropins did not increase cancer risk for these sites. Conclusion Fertility drugs do not appear to have strong effects on these cancers. Nonetheless, follow-up should be pursued to assess long-term risks and to monitor effects among women who remain nulliparous.