Circulating levels of sex steroid hormones and risk of endometrial cancer in postmenopausal women†
Article first published online: 21 OCT 2003
Copyright © 2003 Wiley-Liss, Inc.
International Journal of Cancer
Volume 108, Issue 3, pages 425–432, 20 January 2004
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
Contents of this study are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.
- Issue published online: 21 NOV 2003
- Article first published online: 21 OCT 2003
- Manuscript Accepted: 23 JUL 2003
- Manuscript Revised: 10 JUL 2003
- Manuscript Received: 12 MAR 2003
- US National Cancer Institute. Grant Numbers: R01 CA81212-01, R01 CA81200-01, R01 CA34588, P30 CA16087
- Swedish Cancer Society
- Italian Association of Cancer Research
- endometrial cancer;
- cohort study
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.