Epidemiology

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Circulating levels of sex steroid hormones and risk of endometrial cancer in postmenopausal women†

  1. Annekatrin Lukanova1,2,
  2. Eva Lundin2,3,
  3. Andrea Micheli4,
  4. Alan Arslan5,6,7,
  5. Pietro Ferrari1,
  6. Sabina Rinaldi1,
  7. Vittorio Krogh4,
  8. Per Lenner8,
  9. Roy E. Shore6,7,
  10. Carine Biessy1,
  11. Paola Muti9,
  12. Elio Riboli1,
  13. Karen L. Koenig6,7,
  14. Mortimer Levitz5,6,
  15. Pär Stattin10,
  16. Franco Berrino4,
  17. Göran Hallmans2,
  18. Rudolf Kaaks1,
  19. Paolo Toniolo5,6,7,
  20. Anne Zeleniuch-Jacquotte6,7,‡,*

Article first published online: 21 OCT 2003

DOI: 10.1002/ijc.11529

Issue

International Journal of Cancer

International Journal of Cancer

Volume 108, Issue 3, pages 425–432, 20 January 2004

Additional Information

How to Cite

Lukanova, A., Lundin, E., Micheli, A., Arslan, A., Ferrari, P., Rinaldi, S., Krogh, V., Lenner, P., Shore, R. E., Biessy, C., Muti, P., Riboli, E., Koenig, K. L., Levitz, M., Stattin, P., Berrino, F., Hallmans, G., Kaaks, R., Toniolo, P. and Zeleniuch-Jacquotte, A. (2004), Circulating levels of sex steroid hormones and risk of endometrial cancer in postmenopausal women. Int. J. Cancer, 108: 425–432. doi: 10.1002/ijc.11529

Author Information

  1. 1

    International Agency for Research on Cancer, Lyon, France

  2. 2

    Department of Public Health and Clinical Medicine/Nutritional Research, Umeå University Hospital, Sweden

  3. 3

    Department of Medical Biosciences/Pathology, University of Umeå, Sweden

  4. 4

    Unit of Epidemiology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy

  5. 5

    Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA

  6. 6

    New York University Cancer Institute, New York University School of Medicine, New York, USA

  7. 7

    Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA

  8. 8

    Department of Oncology, Umeå University Hospital, Umeå, Sweden

  9. 9

    Department of Social & Preventive Medicine, State University of New York at Buffalo, School of Medicine & Biomedical Sciences, Buffalo, NY, USA

  10. 10

    Department of Urology and Andrology, Umeå University Hospital, Umeå, Sweden

  1. ‡

    Fax: +1-212-263-8570

*NYU Department of Environmental Medicine, 650 First Ave., Room 539, New York, NY 10016-3240

  1. †

    Contents of this study are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.

Publication History

  1. Issue published online: 21 NOV 2003
  2. Article first published online: 21 OCT 2003
  3. Manuscript Accepted: 23 JUL 2003
  4. Manuscript Revised: 10 JUL 2003
  5. Manuscript Received: 12 MAR 2003

Funded by

  • US National Cancer Institute. Grant Numbers: R01 CA81212-01, R01 CA81200-01, R01 CA34588, P30 CA16087
  • Swedish Cancer Society
  • Italian Association of Cancer Research

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Keywords:

  • estradiol;
  • estrone;
  • testosterone;
  • androstenedione;
  • DHEAS;
  • SHBG;
  • endometrial cancer;
  • cohort study

Abstract

Experimental and epidemiological data support a role for sex steroid hormones in the pathogenesis of endometrial cancer. The associations of pre-diagnostic blood concentrations of estradiol, estrone, testosterone, androstenedione, DHEAS and SHBG with endometrial cancer risk were investigated. A case-control study was nested within 3 cohorts in New York (USA), Umeå (Sweden) and Milan (Italy). Cases were 124 postmenopausal women with invasive endometrial cancer. For each case, 2 controls were selected, matching the case on cohort, age and date of recruitment. Only postmenopausal women who did not use exogenous hormones at the time of blood donation were included. Odds ratios (OR) and their 95% confidence intervals (CI) were estimated by conditional logistic regression. ORs (95% CI) for endometrial cancer for quartiles with the highest hormone levels, relative to the lowest were as follows: 4.13 (1.76–9.72), ptrend = 0.0008 for estradiol, 3.67 (1.71–7.88), ptrend = 0.0007 for estrone, 2.15 (1.05–4.40), ptrend = 0.04 for androstenedione, 1.74 (0.88–3.46), ptrend = 0.06 for testosterone, 2.90 (1.42–5.90), ptrend = 0.002 for DHEAS and 0.46 (0.20–1.05), ptrend = 0.01 for SHBG after adjustment for body mass index, use of oral contraceptives and hormone replacement therapy. The results of our multicenter prospective study showed a strong direct association of circulating estrogens, androgens and an inverse association of SHBG levels with endometrial cancer in postmenopausal women. The effect of elevated androstenedione and testosterone levels on disease risk seems to be mediated mainly through their conversion to estrogens, although an independent effect of androgens on tumor growth cannot be ruled out, in particular in the years close to diagnosis. © 2003 Wiley-Liss, Inc.

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