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Endogenous sex steroids and risk of cervical carcinoma: results from the EPIC study
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2011 (English)In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 20, no 12, 2532-2540 p.Article in journal (Refereed) Published
Abstract [en]

Background: Epidemiologic data and animal models suggest that, despite the predominant role of human papillomavirus infection, sex steroid hormones are also involved in the etiology of invasive cervical carcinoma (ICC).

Methods: Ninety-nine ICC cases, 121 cervical intraepithelial neoplasia grade 3 (CIN3) cases and 2 control women matched with each case for center, age, menopausal status and blood collection-related variables, were identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Circulating levels of testosterone (T) and estradiol (E(2)); dehydroepiandrosterone sulfate (DHEAS); progesterone (premenopausal women); and sex hormone-binding globulin (SHBG) were measured using immunoassays. Levels of free (f) T and E(2) were calculated from absolute concentrations of T, E(2), and SHBG. Odds ratios (ORs) and 95% confidence intervals (CI) were computed using regularized conditional logistic regression.

Results: Among premenopausal women, associations with ICC were observed for fT (OR for highest vs. lowest tertile 5.16, 95% CI, 1.50-20.1). SHBG level was associated with a significant downward trend in ICC risk. T, E(2), fE(2), and DHEAS showed nonsignificant positive association with ICC. Progesterone was uninfluential. Among postmenopausal women, associations with ICC were found for T (OR 3.14; 95% CI, 1.21-9.37), whereas E(2) and fT showed nonsignificant positive association. SHBG level was unrelated to ICC risk in postmenopausal women. No associations between any hormone and CIN3 were detected in either pre- or postmenopausal women.

Conclusions: Our findings suggest for the first time that T and possibly E(2) may be involved in the etiology of ICC. Impact: The responsiveness of cervical tumors to hormone modulators is worth exploring.

Cancer Epidemiol Biomarkers Prev; 20(12); 2532-40. (C) 2011 AACR.

Place, publisher, year, edition, pages
2011. Vol. 20, no 12, 2532-2540 p.
Keyword [en]
breast-cancer risk; collaborative reanalysis; individual data; postmenopausal women; estrogen; serum; nutrition; validity; hormones; contraceptives
National Category
Cancer and Oncology
URN: urn:nbn:se:umu:diva-51485DOI: 10.1158/1055-9965.EPI-11-0753ISI: 000298234900009OAI: diva2:482106
Available from: 2012-01-23 Created: 2012-01-23 Last updated: 2012-01-23Bibliographically approved

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Kjellberg, LennartDillner, Joakim
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