SAT370 Economic Burden of Endometrial Cancer Associated with Polycystic Ovary Syndrome
Authors: Pace Lauren Arielle , Markovic Daniela , Buyalos Richard P , Bril Fernando , Azziz Ricardo 
Published: October 2023

Disclosure: L.A. Pace: None. D. Markovic: None. R.P. Buyalos: Employee; Self; Fertility and Surgical Associates of California. F. Bril: None. R. Azziz: Advisory Board Member; Self; Arora Forge. Consulting Fee; Self; Rani Therapeutics, Spruce Biosciences, Fortress Biotech, Core Access Surgical Technologies. Grant Recipient; Self; Foundation for Research and Education Excellence, Ferring Pharmaceuticals. Stock Owner; Self; Martin Imaging.

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive aged females, affecting approximately 6 million U.S. women. Endometrial cancer, in turn, is the most common gynecological malignancy and the fourth most common cancer overall in female patients. Objectives: To assess the excess economic burden associated with endometrial cancer in women with PCOS. Method: Using PRISMA guidelines for systematic review, we searched PubMed, Web of Science, Scopuse, and Embase for all studies on endometrial cancer in patients with known PCOS. Excluded studies were reviews and case reports, those not conducted in human subjects, without controls, without full text available, or reporting solely on diseases other than PCOS. Selected studies were assessed for quality using the Newcastle-Ottawa Scale. Meta-analysis was performed using the DerSimonian-Laird random effects model to assess the pooled risk ratio (RR) for the association between PCOS and endometrial cancer, then calculation of the excess cost was assessed in U.S. dollars (USD), adjusted for inflation using a medical care inflation calculator. Result: We screened 98 studies by title and abstract, 32 titles in full text, and included 11 articles. Pooled RR was 2.90 (95% CI 1.57-5.37), p=0.0196. In the U.S., overall prevalence of endometrial cancer in patients with PCOS is 0.409%, compared with baseline estimated five-year prevalence (2014-2019) of endometrial cancer in all women of 0.141%, or 235,596 cases. The excess prevalence of endometrial cancer in women with PCOS is therefore 0.2679%, or approximately 361 women. Direct healthcare costs associated with endometrial cancer per patient per year were estimated to be $8,597, when adjusted for inflation to 2022 costs. Therefore, the excess cost of endometrial cancer related to PCOS is estimated at 361 x $8,597 = $3.1 million per year in 2022 USD. Conclusion: In 2022 USD, the excess annual healthcare cost for endometrial cancer care in patients with PCOS exceeds $3 million per year. While the overlap between the risk factors and pathophysiologic underpinnings of both conditions is well-known, PCOS is not always directly addressed as a risk factor for endometrial cancer. Given the findings of this meta-analysis, taken in combination with previously collected data estimating the annual healthcare costs associated with PCOS diagnosis and treatment alone, to exceed $2 billion, we advocate for and increased focus in the global health, policy, and scientific communities to better address this condition and its sequelae. Funding: Foundation for Research and Education Excellence

Presentation Date: Saturday, June 17, 2023