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This review aims to provide an updated overview of the relationship between Polycystic Ovary Syndrome (PCOS) and the development of various types of cancers. PCOS, a condition affecting approximately 5–10% of women of reproductive age, is characterized by oligo- or anovulation, hyperandrogenism, insulin resistance, type II diabetes, hyperlipidemia, obesity, and chronic stress. These factors collectively contribute to an increased risk of cancer in women with PCOS. The hormonal and metabolic imbalances associated with PCOS, such as elevated androgen levels and disrupted ovarian function due to insulin resistance, lead to chronic anovulation. This, in turn, heightens the risk of endometrial cancer. Women with PCOS are reported to have a 2.7-fold increased risk of endometrial cancer compared to those without the condition. Additionally, emerging evidence suggests a link between PCOS and an increased risk of ovarian and breast cancers. Obesity, a common comorbidity in PCOS, exacerbates these risks by elevating levels of ovarian and adrenal androgens, as well as unbound testosterone, which intensifies the clinical and hormonal disturbances of PCOS. Excessive estrogen exposure, chronic anovulation, and elevated androgen levels are critical factors in cancer development. Furthermore, the hormonal profile of PCOS, characterized by elevated androgen, estrogen, and Sex Hormone-Binding Globulin (SHBG) levels, has been implicated in the pathogenesis of breast cancer. In summary, this review highlights the role of hyperandrogenism, obesity, and related metabolic dysfunctions in the development of endometrial, ovarian, and breast cancers in women with PCOS. Understanding these mechanisms underscores the need for targeted strategies to mitigate cancer risks in this population.
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