Anti-Müllerian hormone levels and risk of cancer: A systematic review

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.