Polycystic ovary syndrome and risk of endometrial hyperplasia and endometrial cancer in women with abnormal uterine bleeding: A systematic review and meta-analysis.

This publication reports a systematic review and meta-analysis evaluating whether polycystic ovary syndrome (PCOS) increases the risk of endometrial hyperplasia (EH) and endometrial cancer (EC) among women presenting with abnormal uterine bleeding (AUB).

The authors searched PubMed, Embase, and Web of Science through mid‑September 2025 and included nine retrospective observational studies with a total of 6,064 women with AUB. Of these, 462 (7.6%) had PCOS and 704 (11.6%) were diagnosed with EH and/or EC.

• Overall risk: Using a random-effects model, the presence of PCOS was associated with a significantly higher risk of EH and/or EC (pooled OR 3.28; 95% CI 2.54–4.25; I² = 0%; p < 0.001).
• Robustness of findings: This positive association was stable in sensitivity analyses and across subgroups defined by region, menopausal status, analytic approach, and study quality.
• Risk of EH: When analyzed separately, PCOS was associated with increased risk of EH (OR 3.09; 95% CI 2.49–3.82; p < 0.001).
• Risk of EC: PCOS was associated with an even higher risk of EC (OR 6.98; 95% CI 4.68–10.40; p < 0.001).

The authors conclude that, among women with AUB, those with PCOS have a substantially increased risk of both EH and EC, supporting the need for heightened endometrial surveillance in this high‑risk subgroup.