A Prospective Evaluation of Endogenous Sex Hormone Levels and Colorectal Cancer Risk in Postmenopausal Women

Neil Murphy, Howard Strickler, Frank Z. Stanczyk, Xiaonan (Nan) Xue, Sylvia Wassertheil-Smoller, Thomas E. Rohan, Gloria Y F Ho, Garnet L. Anderson, John D. Potter, Marc J. Gunter

Research output: Contribution to journalArticle

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Abstract

Background: Postmenopausal hormone therapy use has been associated with lower colorectal cancer risk in observational studies. However, the role of endogenous sex hormones in colorectal cancer development in postmenopausal women is uncertain. Methods: The relation of colorectal cancer risk with circulating levels of estradiol, estrone, free (bioactive) estradiol, progesterone and sex hormone-binding globulin (SHBG) was determined in a nested case-control study of 1203 postmenopausal women (401 case patients and 802 age and race/ethnicity-matched control patients) enrolled in the Women's Health Initiative Clinical Trial (WHI-CT) who were not assigned to the estrogen-alone or combined estrogen plus progestin intervention groups. We used multivariable-adjusted conditional logistic regression models that included established colorectal cancer risk factors. All statistical tests were two-sided. Results: Comparing extreme quartiles, estrone (odds ratio [OR]q4-q1 = 0.44, 95% confidence interval [CI] = 0.28 to 0.68, P trend =. 001), free estradiol (ORq4-q1 = 0.43, 95% CI = 0.27 to 0.69, P trend ≤. 0001), and total estradiol (ORq4-q1 = 0.58, 95% CI = 0.38 to 0.90, P trend =. 08) were inversely associated with colorectal cancer risk. SHBG levels were positively associated with colorectal cancer development (OR[q4-q1] = 2.30, 95% CI = 1.51 to 3.51, P trend ≤. 0001); this association strengthened after further adjustment for estradiol and estrone (ORq4-q1 = 2.50, 95% CI = 1.59 to 3.92, P trend

Original languageEnglish (US)
Article numberdjv210
JournalJournal of the National Cancer Institute
Volume107
Issue number10
DOIs
StatePublished - Oct 1 2015

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Gonadal Steroid Hormones
Colorectal Neoplasms
Estradiol
Confidence Intervals
Estrone
Sex Hormone-Binding Globulin
Estrogens
Logistic Models
Odds Ratio
Women's Health
Progestins
Observational Studies
Progesterone
Case-Control Studies
Clinical Trials
Hormones

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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A Prospective Evaluation of Endogenous Sex Hormone Levels and Colorectal Cancer Risk in Postmenopausal Women. / Murphy, Neil; Strickler, Howard; Stanczyk, Frank Z.; Xue, Xiaonan (Nan); Wassertheil-Smoller, Sylvia; Rohan, Thomas E.; Ho, Gloria Y F; Anderson, Garnet L.; Potter, John D.; Gunter, Marc J.

In: Journal of the National Cancer Institute, Vol. 107, No. 10, djv210, 01.10.2015.

Research output: Contribution to journalArticle

Murphy, Neil ; Strickler, Howard ; Stanczyk, Frank Z. ; Xue, Xiaonan (Nan) ; Wassertheil-Smoller, Sylvia ; Rohan, Thomas E. ; Ho, Gloria Y F ; Anderson, Garnet L. ; Potter, John D. ; Gunter, Marc J. / A Prospective Evaluation of Endogenous Sex Hormone Levels and Colorectal Cancer Risk in Postmenopausal Women. In: Journal of the National Cancer Institute. 2015 ; Vol. 107, No. 10.
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abstract = "Background: Postmenopausal hormone therapy use has been associated with lower colorectal cancer risk in observational studies. However, the role of endogenous sex hormones in colorectal cancer development in postmenopausal women is uncertain. Methods: The relation of colorectal cancer risk with circulating levels of estradiol, estrone, free (bioactive) estradiol, progesterone and sex hormone-binding globulin (SHBG) was determined in a nested case-control study of 1203 postmenopausal women (401 case patients and 802 age and race/ethnicity-matched control patients) enrolled in the Women's Health Initiative Clinical Trial (WHI-CT) who were not assigned to the estrogen-alone or combined estrogen plus progestin intervention groups. We used multivariable-adjusted conditional logistic regression models that included established colorectal cancer risk factors. All statistical tests were two-sided. Results: Comparing extreme quartiles, estrone (odds ratio [OR]q4-q1 = 0.44, 95{\%} confidence interval [CI] = 0.28 to 0.68, P trend =. 001), free estradiol (ORq4-q1 = 0.43, 95{\%} CI = 0.27 to 0.69, P trend ≤. 0001), and total estradiol (ORq4-q1 = 0.58, 95{\%} CI = 0.38 to 0.90, P trend =. 08) were inversely associated with colorectal cancer risk. SHBG levels were positively associated with colorectal cancer development (OR[q4-q1] = 2.30, 95{\%} CI = 1.51 to 3.51, P trend ≤. 0001); this association strengthened after further adjustment for estradiol and estrone (ORq4-q1 = 2.50, 95{\%} CI = 1.59 to 3.92, P trend",
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AU - Wassertheil-Smoller, Sylvia

AU - Rohan, Thomas E.

AU - Ho, Gloria Y F

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