调查不孕与浸润性癌症之间的关联关系。前瞻性队列研究（1989-2015）。参与护士健康研究II的103,080名25-42岁的女性，在基线（1989年）时没有患癌症。在基线和两年随访问卷中报告不孕状态（尝试一年后未能怀孕）和不孕病因。通过医学记录审核确认癌症诊断，并将其分类为肥胖相关癌症（结直肠、胆囊、肾脏、多发性骨髓瘤、甲状腺、胰腺、食道、胃、肝脏、子宫内、卵巢和绝经后乳腺癌）或非肥胖相关癌症（所有其他癌症）。我们拟合Cox比例风险模型，以估算不孕与癌症发生率之间的关联的危险比（HR）和95%置信区间（CI）。在2,149,385人年的随访中，26,208名女性报告了不孕史，我们记录了6,925例侵袭性癌症病例。在调节身体质量指数（BMI）和其他风险因素后，相比未曾经历不孕病史的孕产妇，报告不孕的女性患癌症的风险更大（HR = 1.07，95% CI，1.02-1.13）。在肥胖相关癌症中，该关联更为显著（HR = 1.13，95% CI，1.05-1.22；相比非肥胖相关癌症，HR = 0.98，95% CI，0.91-1.06）。在特定的肥胖相关生殖癌症（绝经后乳腺癌、子宫内和卵巢癌）中，该关联更为显著（HR = 1.17，95% CI，1.06-1.29），而在在生活中首次报告不孕的女性中更为显著（≤25岁：HR = 1.19，95% CI，1.07- 1.33；26-30岁：HR = 1.11，95% CI，0.99-1.25；> 30岁：HR = 1.07，95% CI，0.94-1.22；P趋势<0.001）。不孕史可能与发展肥胖相关的生殖癌症有关，需要进一步研究以阐明其潜在机制。版权所有 © 2023。Elsevier Inc.出版。

To investigate the association between infertility and incidence of invasive cancer.Prospective cohort study (1989-2015).103,080 women aged 25-42 years in the Nurses' Health Study II who were cancer free at baseline (1989).Infertility status (failure to conceive after one year of trying) and causes of infertility were self-reported at baseline and biennial follow-up questionnaires.Cancer diagnosis was confirmed through medical record review and classified as obesity-related (colorectal, gallbladder, kidney, multiple myeloma, thyroid, pancreatic, esophageal, gastric, liver, endometrial, ovarian, and post-menopausal breast) or non-obesity-related (all other cancers). We fit Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the association between infertility and cancer incidence.During 2,149,385 person-years of follow-up, 26,208 women reported a history of infertility, and we documented 6,925 incident invasive cancer cases. After adjusting for body mass index (BMI) and other risk factors, women reporting infertility had a greater risk of developing cancer compared to gravid women without a history of infertility (HR=1.07; 95% CI, 1.02-1.13). This association was stronger among obesity-related cancers (HR=1.13; 95% CI, 1.05-1.22; vs non-obesity-related cancers, HR=0.98; 95% CI, 0.91-1.06), and in particular, obesity-related reproductive cancers (post-menopausal breast, endometrial, and ovarian cancer; HR=1.17, 95% CI, 1.06-1.29) and was stronger among women first reporting infertility earlier in life (≤25 years: HR=1.19, 95% CI, 1.07-1.33; 26-30 years: HR=1.11, 95% CI, 0.99-1.25; >30 years: HR=1.07, 95% CI, 0.94-1.22; P trend<0.001).History of infertility may be associated with risk of developing obesity-related reproductive cancers; further study is needed to elucidate underlying mechanisms.Copyright © 2023. Published by Elsevier Inc.