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Objective To investigate the risks of ovarian, breast, and corpus uteri cancer in women who have had assisted reproduction. Design Large, population based, data linkage cohort study. Setting and participants All women who had assisted reproduction in Great Britain, 1991-2010, as recorded by the Human Fertilisation and Embryology Authority (HFEA). Interventions HFEA fertility records for cohort members were linked to national cancer registrations. Main outcome measures Observed first diagnosis of ovarian, breast, and corpus uteri cancer in cohort members were compared with age, sex, and period specific expectation. Standardised incidence ratios (SIRs) were calculated by use of age, sex, and period specific national incidence rates. Results 255 786 women contributed 2 257 789 person years’ follow-up. No significant increased risk of corpus uteri cancer (164 cancers observed v 146.9 cancers expected; SIR 1.12, 95% confidence interval 0.95 to 1.30) was found during an average of 8.8 years’ follow-up. This study found no significantly increased risks of breast cancer overall (2578 v 2641.2; SIR 0.98, 0.94 to 1.01) or invasive breast cancer (2272 v 2371.4; SIR 0.96, 0.92 to 1.00). An increased risk of in situ breast cancer (291 v 253.5; SIR 1.15, 1.02 to 1.29; absolute excess risk (AER) 1.7 cases per 100 000 person years, 95% confidence interval 0.2 to 3.2) was detected, associated with an increasing number of treatment cycles (P=0.03). There was an increased risk of ovarian cancer (405 v 291.82; SIR 1.39, 1.26 to 1.53; AER 5.0 cases per 100 000 person years, 3.3 to 6.9), both invasive (264 v 188.1; SIR 1.40, 1.24 to 1.58; AER 3.4 cases per 100 000 person years, 2.0 to 4.9) and borderline (141 v 103.7; SIR 1.36, 1.15 to 1.60; AER 1.7 cases per 100 000 person years, 0.7 to 2.8). Increased risks of ovarian tumours were limited to women with endometriosis, low parity, or both. This study found no increased risk of any ovarian tumour in women treated because of only male factor or unexplained infertility. Conclusions No increased risk of corpus uteri or invasive breast cancer was detected in women who had had assisted reproduction, but increased risks of in situ breast cancer and invasive and borderline ovarian tumours were found in this study. Our results suggest that ovarian tumour risks could be due to patient characteristics, rather than assisted reproduction itself, although both surveillance bias and the effect of treatment are also possibilities. Ongoing monitoring of this population is essential.

BACKGROUND: Breakthroughs in the treatment of preterm birth approximately 40 years ago have enabled a generation of preterm survivors to now reach mid-adulthood. Understanding their health sequelae is essential for guiding their long-term care. We conducted the first study to examine preterm birth in relation to mortality into mid-adulthood. METHODS: A national cohort study was conducted of all 4,296,814 singleton live births in Sweden in 1973–2015, who were followed up for mortality through 2017 (maximum age 45 years). Cox regression was used to examine gestational age at birth in relation to all-cause and cause-specific mortality, and co-sibling analyses assessed for potential confounding by shared familial (genetic and/or environmental) factors. FINDINGS: There were 43,916 (1·0%) deaths in 103·5 million person-years of follow-up. Gestational age at birth was inversely associated with mortality from infancy into mid-adulthood. Relative to full-term birth (39–41 weeks), adjusted hazard ratios for mortality associated with extremely preterm (22–27 weeks), very preterm (28–33 weeks), late preterm (34–36 weeks), and early term (37–38 weeks) birth were 66·14 (95% CI, 63·09–69·34), 8·67 (8·32–9·03), 2·61 (2·52–2·71), and 1·34 (1·30–1·37), respectively, at ages 0–45 years; and 2·04 (95% CI, 0·92–4·55), 1·48 (1·17–1·87), 1·22 (1·07–1·39), and 1·16 (1·08–1·25), respectively, at ages 30–45 years. Preterm birth accounted for more deaths among males than females (additive interaction, P