- •Higher levels of anti-Müllerian hormone (AMH) are linked to a higher risk of breast cancer.
- •Associations with other cancer types cannot be excluded based on current evidence.
- •Most studies on pretreatment levels of anti-Müllerian hormone did not adequately adjust for age.
- •Future research should include younger participants and repeated measurements of anti-Müllerian hormone.
Experimental research suggests that anti-Müllerian hormone (AMH) inhibits tumor growth. Conversely, epidemiological studies suggest that higher AMH concentrations increase breast cancer risk, while associations with other cancers are inconsistent. Therefore, our aim was to provide a systematic review of current epidemiological evidence on AMH levels in relation to different cancer types. We performed a systematic search of PubMed and Embase for publications on circulating AMH in relation to cancer. Methodological quality of articles was assessed using the Study Quality Assessment Tools of the National Heart, Lung and Blood Institute. We included 12 articles on breast, ovarian and endometrial cancer, lymphomas, non-gynaecological cancers, childhood cancer and prostate cancer. Five studies measured AMH prior to cancer diagnosis; the other studies measured AMH after diagnosis but prior to treatment. Higher prediagnosis AMH levels were associated with an increased risk of breast cancer. Associations with other types of cancer remained inconclusive, although analyses stratified by age hinted at an increased risk of ovarian and endometrial cancer in younger women. Pretreatment AMH levels were lower in women diagnosed with different types of cancer compared with AMH levels in healthy women. However, because we considered most of the studies that established pretreatment AMH levels to be of poor methodological quality, mainly because of inadequate correction for age at measurement and other important confounders, we refrain from definite conclusions based on these results. Future studies with young participants are needed to assess whether and how AMH affects the risk of different cancer types over time.
Abbreviations:AMH (anti-Müllerian hormone), AMHR2 (AMH receptor type 2), IPD (individual participant data), sd (standard deviation), IQR (interquartile range), OR (odds ratio), 95 % CI (95 % confidence interval), NHLBI (National Heart, Lung and Blood Institute), SDS (standard deviation scores)
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Published online: March 09, 2020
Accepted: March 7, 2020
Received in revised form: January 21, 2020
Received: November 18, 2019
© 2020 Elsevier B.V. All rights reserved.