{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:52:10Z","timestamp":1791179530386,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2018R1D1A1B07048821"],"award-info":[{"award-number":["2018R1D1A1B07048821"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2022R1A2C1006364"],"award-info":[{"award-number":["2022R1A2C1006364"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether dienogest exposure is associated with the risk of breast, endometrial, or tubo\u2010ovarian cancer in women with endometriosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this nationwide retrospective cohort study (January 2012 to December 2023), we used the Korean National Health Insurance Review &amp; Assessment Service database. Women aged 20\u201349\u2009years with endometriosis who received dienogest for at least 6\u2009months were compared with an active control group treated with gonadotropin\u2010releasing hormone (GnRH) agonists, with cohorts balanced by inverse probability of treatment weighting. Incident breast, endometrial, and tubo\u2010ovarian cancers were ascertained, and adjusted hazard ratios (aHR) were estimated using Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1\u2009887\u2009957 women with endometriosis, 14\u2009647 dienogest users and 181\u2009587 GnRH agonist users met the eligibility criteria for the breast cancer cohort; sample sizes were similar for endometrial and tubo\u2010ovarian analyses. Compared with GnRH agonists, dienogest use was not associated with increased risk of breast cancer (aHR 1.01, 95% confidence interval [CI] 0.75\u20131.37), endometrial cancer (aHR 0.84, 95% CI 0.40\u20131.77), or tubo\u2010ovarian cancer (aHR 0.92, 95% CI 0.30\u20132.80). Use of dienogest for 0.5\u20131.5\u2009years was associated with a reduced breast cancer risk (aHR 0.72, 95% CI 0.53\u20130.99), whereas associations for longer durations were inconsistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Dienogest use in women with endometriosis was not associated with higher or lower risks of breast, endometrial, or tubo\u2010ovarian cancer compared with GnRH agonists, supporting its oncologic safety. Further longer\u2010term studies are warranted to clarify duration\u2010specific effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70424","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T12:20:53Z","timestamp":1753791653000},"page":"1123-1129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Dienogest use and the risk of breast and gynecologic cancers: A nationwide population\u2010based study"],"prefix":"10.1002","volume":"172","author":[{"given":"Hoyol","family":"Jhang","sequence":"first","affiliation":[{"name":"Department of Public Health Korea University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saerom","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Public Health Korea University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun\u2010Tae","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Korea University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju\u2010Young","family":"Shin","sequence":"additional","affiliation":[{"name":"School of Pharmacy Sungkyunkwan University  Suwon Republic of Korea"},{"name":"Department of Clinical Research Design &amp; Evaluation, Samsung Advanced Institute for Health Sciences &amp; Technology (SAIHST) Sungkyunkwan University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6270-5020","authenticated-orcid":false,"given":"Seung\u2010Ah","family":"Choe","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Korea University College of Medicine  Seoul Republic of Korea"},{"name":"Research and Management Center for Health Risk of Particulate Matter Korea University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xfre.2022.11.009"},{"key":"e_1_2_9_3_1","unstructured":"Bayer receives approval in China for endometriosis treatment Visanne\u2122.https:\/\/www.bayer.com\/media\/en\u2010us\/bayer\u2010receives\u2010approval\u2010in\u2010china\u2010for\u2010endometriosis\u2010treatment\u2010visannetm\/"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-36291-1"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmaa045"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnz001"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnad018"},{"key":"e_1_2_9_8_1","first-page":"593","article-title":"Postmenopausal estrogen and progestin use in relation to breast cancer Risk1","volume":"11","author":"Newcomb PA","year":"2002","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0014-2999(99)00765-7"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S5633"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31802d68ce"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-008-9125-x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2021.044"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-021-00295-9"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590902836536"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tranon.2025.102387"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14930"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.27623"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.01918"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab195"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.9210"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.4048\/jbc.2024.0213"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-023-07211-8"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2021.01.019"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2024.35.e32"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13048-021-00940-8"}],"container-title":["International Journal of Gynecology &amp; 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