HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article IMMEDIATE FREE ACCESS ARTICLE OA Free Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Allen, N. E Articles by Kaaks, R. PubMed PubMed Citation Articles by Allen, N. E Articles by Kaaks, R.

Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, UK¹ Nutrition and Hormones Group, International Agency for Research on Cancer, Lyon, France² University of Sydney, Sydney, Australia and University of Lyon, Lyon, France³ Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands⁴ Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge, UK⁵ Epidemiology Unit, Istituto Tumori, Milan, Italy⁶ Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy⁷ Public Health Department of Gipuzkoa, Basque Government, San Sebastian, Spain⁸ Department of Epidemiology, Catalan Institute of Oncology (ICO), Barcelona, Spain⁹ Consejería de Sanidad y Política Social, Murcia, Spain¹⁰ Andalusian School of Public Health, Granada, Spain¹¹ Public Health & Health Planning Directorate, Asturias, Spain¹² Instituto de Salud Pública de Navarra, Pamplona, Spain¹³ Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark¹⁴ Division of Cancer Epidemiology, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany¹⁵ German Institute of Human Nutrition, Potsdam-Rehbücke, Germany¹⁶ Department of Nutritional Research, University of Umeå, Umeå, Sweden¹⁷ Molecular and Nutritional Epidemiology Unit, CSPO-Scientific Institute of Tuscany, Florence, Italy¹⁸ Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark¹⁹ Inserm E3N-EPIC, Institute Gustave Roussy, Villejuif, France²⁰ MRC Dunn Human Nutrition Unit, University of Cambridge, Cambridge, UK²¹ Clinical Gerontology Unit, Addenbrooke's Hospital, Cambridge, UK²² National Institute of Public Health and the Environment, Center for Nutrition and Health, Bilthoven, The Netherlands²³ Department of Hygiene and Epidemiology, School of Medicine, University of Athens, Athens, Greece²⁴ Cancer Registry, Azienda Ospedaliera ‘Civile M P Arezzo’, Ragusa, Italy²⁵ Cancer Epidemiology and Prevention, Department of Epidemiology and Public Health, Faculty of Medicine, Imperial College London, London, UK

(Correspondence should be addressed to R Kaaks; Email: r.kaaks{at}dkfz.de)

Epidemiological data show that reproductive and hormonal factors are involved in the etiology of endometrial cancer, but there is little data on the association with endogenous sex hormone levels. We analyzed the association between prediagnostic serum concentrations of sex steroids and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition using a nested case–control design of 247 incident endometrial cancer cases and 481 controls, matched on center, menopausal status, age, variables relating to blood collection, and, for premenopausal women, phase of menstrual cycle. Using conditional regression analysis, endometrial cancer risk among postmenopausal women was positively associated with increasing levels of total testosterone, free testosterone, estrone, total estradiol, and free estradiol. The odds ratios (ORs) for the highest versus lowest tertile were 2.66 (95% confidence interval (CI) 1.50–4.72; P=0.002 for a continuous linear trend) for estrone, 2.07 (95% CI 1.20–3.60; P=0.001) for estradiol, and 1.66 (95% CI 0.98–2.82; P=0.001) for free estradiol. For total and free testosterone, ORs for the highest versus lowest tertile were 1.44 (95% CI 0.88–2.36; P=0.05) and 2.05 (95% CI 1.23–3.42; P=0.005) respectively. Androstenedione and dehydroepiandrosterone sulfate were not associated with risk. Sex hormone-binding globulin was significantly inversely associated with risk (OR for the highest versus lowest tertile was 0.57, 95% CI 0.34–0.95; P=0.004). In premenopausal women, serum sex hormone concentrations were not clearly associated with endometrial cancer risk, but numbers were too small to draw firm conclusions. In conclusion, relatively high blood concentrations of estrogens and free testosterone are associated with an increased endometrial cancer risk in postmenopausal women.