{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T04:13:21Z","timestamp":1784002401194,"version":"3.55.0"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n High-quality evidence on cancer occurrence for women who have used medically assisted reproduction (MAR) is required to guide care.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare cancer incidence in MAR-exposed women with the general population of women.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This is a population-based cohort study of Australian women. MAR treatments, pregnancies, incident cancers, and deaths were ascertained using linkage between population-based administrative health datasets and statutory registries. Women aged 18 to 55 years who used MAR from 1991 to 2018 were identified and analyzed from April to November 2024.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Three MAR cohorts were created: assisted reproductive therapy (ART), intrauterine insemination with ovarian stimulation (IUI\/OS), and ovulation induction using clomiphene citrate (clomiphene citrate).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Cancer incidence among MAR-exposed women was compared with the age-, jurisdiction-, and calendar year\u2013matched general population. The main outcomes were cancer standardized incidence ratios (SIRs) and rate differences.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 417\u202f984 MAR-exposed women were included, with 274\u202f676 (65.7%) having ever used ART (median [IQR] age, 34 [31-38] years; median [IQR] follow-up time, 9.42 [5.08-15.42] years), 120\u202f739 (28.9%) having ever used IUI\/OS (median [IQR] age, 34 [30-38] years; median [IQR] follow-up time, 11.67 [6.25-18.42] years), and 175\u202f510 (42.0%) having ever used clomiphene citrate (median [IQR] age, 32 [28-36] years; median [IQR] follow-up time, 9.42 [5.42-13.58] years). The overall incidence of invasive cancer was comparable with the general population for the ART (SIR, 1.00; 95% CI, 0.98-1.02) and IUI\/OS (SIR, 0.99; 95% CI, 0.97-1.02) cohorts and slightly elevated for the clomiphene citrate cohort (SIR, 1.04; 95% CI, 1.00-1.07). For all cohorts, incidence of uterine cancer (SIRs, 1.23-1.83) and in situ and invasive melanoma (SIRs, 1.07-1.15) were elevated, and incidence of cervical cancer (SIRs, 0.52-0.61) and cancer of the trachea, bronchus, and lung (SIRs, 0.62-0.70) were lower. Ovarian cancer incidence was elevated for the ART (SIR, 1.23; 95% CI, 1.10-1.37) and IUI\/OS (SIR, 1.18; 95% CI, 1.01-1.37) cohorts. In situ breast cancer incidence was elevated for the ART cohort only (SIR, 1.24; 95% CI, 1.12-1.38). Incidence of invasive breast cancer was not elevated. Rate differences for invasive cancers with elevated incidence were all small (&amp;lt;1 to 6.51 cases per 100\u202f000 person-years).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of cancer incidence in women who received MAR, the overall incidence of cancer was comparable with that of the general population. The incidence of certain cancers appeared elevated; however, the excess numbers of these cancers were small, and there was reduced incidence of other cancers. Causation cannot be inferred from this descriptive evidence, but findings may guide women and their health care practitioners.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.1332","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T15:00:18Z","timestamp":1773154818000},"page":"e261332","source":"Crossref","is-referenced-by-count":6,"title":["Cancer Incidence in Women After Medically Assisted Reproduction"],"prefix":"10.1001","volume":"9","author":[{"given":"Claire Melissa","family":"Vajdic","sequence":"first","affiliation":[{"name":"Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian Raymond","family":"Walker","sequence":"additional","affiliation":[{"name":"Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoinette C.","family":"Anazodo","sequence":"additional","affiliation":[{"name":"Kids Cancer Centre, Sydney Children\u2019s Hospital, Randwick, New South Wales, Australia"},{"name":"Women\u2019s Health, Paediatrics & Child Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neville F.","family":"Hacker","sequence":"additional","affiliation":[{"name":"Women\u2019s Health, Paediatrics & Child Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Chapman","sequence":"additional","affiliation":[{"name":"Women\u2019s Health, Paediatrics & Child Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"IVF Australia Southern Sydney, Sydney, New South Wales, Australia"},{"name":"St George Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Signe","family":"Opdahl","sequence":"additional","affiliation":[{"name":"Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louisa","family":"Jorm","sequence":"additional","affiliation":[{"name":"Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Norman","sequence":"additional","affiliation":[{"name":"Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharyn","family":"Stern","sequence":"additional","affiliation":[{"name":"Melbourne IVF, Melbourne, Victoria, Australia"},{"name":"Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula M.","family":"Sansom-Daly","sequence":"additional","affiliation":[{"name":"Kids Cancer Centre, Sydney Children\u2019s Hospital, Randwick, New South Wales, Australia"},{"name":"Behavioural Sciences Unit, Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW, Randwick, New South Wales, Australia"},{"name":"Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina Mary","family":"Chambers","sequence":"additional","affiliation":[{"name":"Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Venetis","sequence":"additional","affiliation":[{"name":"Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Unit for Human Reproduction, 1st Dept of Ob\/Gyn, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"issue":"5","key":"zoi260072r1","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1093\/humrep\/deac032","article-title":"Population-wide contribution of medically assisted reproductive technologies to overall births in Australia: temporal trends and parental 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