Highlights
- •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.
Abstract
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)Keywords
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References
- Ovarian function, fertility and reproductive lifespan in cancer patients.Expert Rev. Endocrinol. Metab. 2018; 13: 125-136
- Mullerian inhibiting substance/anti-Mullerian hormone: a potential therapeutic agent for human ovarian and other cancers.Future Oncol. 2010; 6: 391-405
- Mullerian inhibiting substance/anti-Mullerian hormone: a novel treatment for gynecologic tumors.Obstet. Gynecol. Sci. 2014; 57: 343-357
- Potential therapeutic applications of human anti-Mullerian hormone (AMH) analogues in reproductive medicine.J. Assist. Reprod. Genet. 2017; 34: 1105-1113
- Highly purified mullerian inhibiting substance inhibits human ovarian cancer in vivo.Clin. Cancer Res. 2002; 8: 2640-2646
- Mullerian inhibiting substance inhibits breast cancer cell growth through an NFkappa B-mediated pathway.J. Biol. Chem. 2000; 275: 28371-28379
- Mullerian inhibiting Substance induces NFkB signaling in breast and prostate cancer cells.Mol. Cell. Endocrinol. 2003; 211: 43-49
- Mullerian-inhibiting substance regulates NF-kappa B signaling in the prostate in vitro and in vivo.Proc. Natl. Acad. Sci. U. S. A. 2002; 99: 239-244
- Mullerian inhibiting substance type II receptor (MISIIR): a novel, tissue-specific target expressed by gynecologic cancers.Gynecol. Oncol. 2008; 108: 141-148
- Circulating anti-Mullerian hormone and breast cancer risk: a study in ten prospective cohorts.Int. J. Cancer. 2018; 142: 2215-2226
- Anti-Mullerian hormone and risk of ovarian cancer in nine cohorts.Int. J. Cancer. 2018; 142: 262-270
- Anti-Mullerian hormone and risk of invasive serous ovarian cancer.Cancer Causes Control. 2014; 25: 583-589
- Prediagnostic circulating anti-Mullerian hormone concentrations are not associated with prostate cancer risk.Cancer Epidemiol. Biomarkers Prev. 2014; 23: 2597-2602
- The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.PLoS Med. 2009; 6e1000100
- The role of antimullerian hormone in assessing ovarian damage from chemotherapy, radiotherapy and surgery.Curr. Opin. Endocrinol. Diabetes Obes. 2018; 25: 391-398
- Prospective case-control study of serum mullerian inhibiting substance and breast cancer risk.J. Natl. Cancer Inst. 2009; 101: 1501-1509
- Anti-Mullerian hormone concentrations in premenopausal women and breast cancer risk.Cancer Prev. Res. (Phila). 2015; 8: 528-534
- Plasma anti-mullerian hormone concentrations and risk of breast Cancer among premenopausal women in the nurses’ health studies.Cancer Epidemiol. Biomarkers Prev. 2016; 25: 854-860
- Study Quality Assessment Tools.([cited 2019, July 31]. Available from:)
- Impact of breast cancer on anti-mullerian hormone levels in young women.Breast Cancer Res. Treat. 2013; 137: 571-577
- Chemotherapy: impact on anti-mullerian hormone levels in breast carcinoma.J. Clin. Diagn. Res. 2016; 10: BC19-21
- Predictors of ovarian reserve in young women with breast cancer.Br. J. Cancer. 2007; 96: 1808-1816
- Anti-Mullerian hormone and endometrial cancer: a multi-cohort study.Br. J. Cancer. 2017; 117: 1412-1418
- Reduced pretreatment ovarian reserve in premenopausal female patients with Hodgkin lymphoma or non-Hodgkin-lymphoma--evaluation by using antimullerian hormone and retrieved oocytes.Fertil. Steril. 2012; 98: 141-144
- Female patients with lymphoma demonstrate diminished ovarian reserve even before initiation of chemotherapy when compared with healthy controls and patients with other malignancies.J. Assist. Reprod. Genet. 2016; 33: 657-662
- New insights in the selection and management of cancer patients applicants for ovarian tissue cryopreservation.Gynecol. Endocrinol. 2016; 32: 881-885
- Decreased serum anti-Mullerian hormone levels in girls with newly diagnosed cancer.Hum. Reprod. 2014; 29: 337-342
- Antimullerian hormone: correlation with age and androgenic and metabolic factors in women from birth to postmenopause.Fertil. Steril. 2016; 105 (e481): 481-485
- Back to the basics of ovarian aging: a population-based study on longitudinal anti-Mullerian hormone decline.BMC Med. 2016; 14: 151
- Serum variations of anti-mullerian hormone and total testosterone with aging in healthy adult Iranian men: a population-based study.PLoS One. 2017; 12e0179634
- Selection of confounding variables should not be based on observed associations with exposure.Eur. J. Epidemiol. 2011; 26: 589-593
- Is the plasma anti-Mullerian hormone (AMH) level associated with body weight and metabolic, and hormonal disturbances in women with and without polycystic ovary syndrome?.Eur. J. Obstet. Gynecol. Reprod. Biol. 2011; 158: 254-259
- Anti-Mullerian hormone: correlation with testosterone and oligo- or amenorrhoea in female adolescence in a population-based cohort study.Hum. Reprod. 2014; 29: 2317-2325
- Meta-analysis using individual participant data: one-stage and two-stage approaches, and why they may differ.Stat. Med. 2017; 36: 855-875
- Anti-mullerian hormone as a predictor of time to menopause in late reproductive age women.J. Clin. Endocrinol. Metab. 2012; 97: 1673-1680
- Does anti-Mullerian hormone predict menopause in the general population? Results of a prospective ongoing cohort study.Hum. Reprod. 2016; 31: 1579-1587
- Menarche, menopause, and breast cancer risk: individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies.Lancet Oncol. 2012; 13: 1141-1151
- Reproductive risk factors and breast cancer subtypes: a review of the literature.Breast Cancer Res. Treat. 2014; 144: 1-10
- Large-scale genomic analyses link reproductive aging to hypothalamic signaling, breast cancer susceptibility and BRCA1-mediated DNA repair.Nat. Genet. 2015; 47: 1294-1303
- Epidemiology of ovarian cancer: a review.Cancer Biol. Med. 2017; 14: 9-32
- Reproductive risk factors and endometrial cancer: the European Prospective Investigation into Cancer and Nutrition.Int. J. Cancer. 2010; 127: 442-451
Article info
Publication history
Published online: March 09, 2020
Accepted:
March 7,
2020
Received in revised form:
January 21,
2020
Received:
November 18,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.