RESEARCH QUESTION Current knowledge of cancer risk among women who undergo IVF is based mainly on studies of women treated in their thirties, frequently with short follow-up periods. Therefore, information about cancer risk among infertile menopausal women is limited. We aimed to evaluate the risk of cancer among IVF patients treated at age 40 years and older, followed up for an extended period. DESIGN Historical cohort study of all IVF patients treated at the age of 40 years or older at two university-affiliated IVF units in Jerusalem, Israel, between 1994 and 2002. Data were cross-linked with the Israel National Cancer Registry to 2016. Standardized incidence ratios (SIR) and 95% confidence intervals were computed by comparing the observed number of cancer cases with the expected cancer rate in the general Israeli population adjusted for age and year of birth. In addition, Kaplan-Meier analysis was conducted to account for the length of follow-up. RESULTS A total of 501 patients were included in the analysis, with mean follow-up of 16.7 ± 3.7 years (range 2-22 years). Mean age at first IVF cycle was 42.3 years (±2.1). Mean number of IVF cycles was 3.2 ± 2.6 (range 1-15). Thirty-six women (7.2%) developed invasive cancer, compared with 47.2 expected cases; SIR 0.76 (95% CI 0.53 to 1.06); 22 women were diagnosed with invasive breast cancer, compared with 19.84 expected; SIR 1.11 (95% CI 0.69 to 1.68). CONCLUSIONS Older women undergoing IVF treatment were not significantly associated with an excess risk of cancer at long-term follow up. Further studies, however, are needed to confirm these findings.

中文翻译：

---

在40岁及以上接受治疗的IVF患者中的癌症：长期随访。

研究问题当前接受IVF的女性对癌症风险的了解主要基于对30多岁，经常有较短随访期的女性的研究。因此，有关不育绝经妇女中癌症风险的信息是有限的。我们旨在评估在40岁及40岁以上接受IVF治疗的患者中进行长期随访的癌症风险。设计在1994年至2002年之间，对以色列耶路撒冷的两个大学附属IVF单元中接受治疗的所有40岁或40岁以上的IVF患者进行了历史队列研究。数据与以色列国家癌症登记处进行了交叉关联，直至2016年。通过将观察到的癌症病例数与按年龄和出生年份进行调整的以色列总人口中的预期癌症发生率进行比较，计算出标准化的发病率（SIR）和95％的置信区间。此外，进行了Kaplan-Meier分析以说明随访时间。结果本研究共纳入501例患者，平均随访时间为16.7±3.7年（范围2-22年）。第一个试管婴儿周期的平均年龄为42.3岁（±2.1）。IVF周期的平均数为3.2±2.6（范围1-15）。三十六名妇女（7.2％）患了浸润性癌症，而预期病例为47.2名；SIR 0.76（95％CI 0.53至1.06）; 22名女性被诊断为浸润性乳腺癌，预期为19.84；SIR 1.11（95％CI 0.69至1.68）。结论接受IVF治疗的老年妇女在长期随访中与癌症的额外风险没有显着相关。但是，需要进一步的研究来证实这些发现。