Zahed Karimi
1 
, Sara Abutalebi Nasrabad
2 , Reza Farzaneh
3 , Seyed Amir Banikarim
4 , Farkhondeh Sameipoor
5 , Faezeh Khajeh
6 , Faezeh Nesaei
7 , Roya Raeisi Jaski
8 , Maryam Samadi
9 , Naeem Nikpour
10* 1 Department of Internal Medicine, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
2 Department of Obstetrics and Gynecology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3 Department of Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
4 Hematology-Oncology Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
5 Department of Operating Room, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
6 Department of Anesthesiology, School of Paramedical Sciences, Gonabad University of Medical Sciences, Gonabad, Iran
7 Department of Nursing, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
8 Department of Anesthesia Nursing, Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
9 Department of Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
10 Department of Hematology and Medical Oncology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
Abstract
The mechanistic sequence from hyperandrogenism to tumorigenesis in women with polycystic ovary syndrome (PCOS) encompasses a constellation of structural and functional aberrations spanning the endocrine, metabolic, immunologic, and genetic domains. Chronic hyperandrogenism incites an interconnected cascade through chronic anovulation and unopposed estrogen action, insulin resistance with hyperinsulinemia, low-grade systemic inflammation, oxidative stress, and gut dysbiosis, each playing a synergistic role in promoting oncogenesis. It has been demonstrated that, this syndrome is most strongly associated with an increased risk of endometrial cancer, with a more modest and less consistent association with ovarian and breast cancers. Thyroid cancer risk may also be elevated, particularly in younger women. The underlying mechanisms involve hormonal imbalances, metabolic dysfunction, chronic inflammation, and genetic predisposition. Women with PCOS should be monitored for early signs of these cancers, and management should focus on mitigating risk factors such as obesity, insulin resistance, and chronic anovulation.
Citation: Karimi Z, Abutalebi Nasrabad S, Farzaneh R, Banikarim SA, Sameipoor F, Khajeh F, Nesaei F, Raeisi Jaski R, Samadi M, Nikpour N. From hyperandrogenism to tumorigenesis; a mechanistic perspective on cancer development in PCOS-affected women. Immunopathol Persa. 2026;12(2):e44029. DOI:10.34172/ipp.2026.44029.