Plasma sex steroid hormone levels and risk of breast cancer in postmenopausal women

被引:545
作者
Hankinson, SE
Willett, WC
Manson, JE
Colditz, GA
Hunter, DJ
Spiegelman, D
Barbieri, RL
Speizer, FE
机构
[1] Brigham & Womens Hosp, Channing Lab, Dept Med, Div Prevent Med, Boston, MA 02115 USA
[2] Harvard Univ, Sch Med, Boston, MA USA
[3] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA
[4] Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA
[5] Harvard Univ, Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA
[6] Brigham & Womens Hosp, Dept Obstet & Gynecol, Boston, MA 02115 USA
[7] Harvard Univ, Sch Publ Hlth, Dept Environm Hlth, Boston, MA 02115 USA
来源
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 1998年 / 90卷 / 17期
基金
美国国家卫生研究院;
关键词
D O I
10.1093/jnci/90.17.1292
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: A positive relationship has generally been observed between plasma estrogen levels and breast cancer risk in postmenopausal women, but most of these studies have been small and few have evaluated specific estrogen fractions (such as percent bioavailable estradiol). In addition, few studies have evaluated plasma and androgen levels in relation to breast cancer risk, and their results have been inconsistent. We prospectively evaluated relationships between sex steroid hormone levels in plasma and risk of breast cancer in postmenopausal women by use of a case-control study nested within the Nurses' Health Study. Methods: Blood samples were collected during the period from 1989 through 1990. Among postmenopausal women not using hormone replacement therapy at blood collection (n = 11 169 women), 156 women were diagnosed with breast cancer after blood collection but before June 1, 1994. Two control subjects were selected per case subject and matched with respect to age, menopausal status, month and time of day of blood collection, and fasting status at the time of blood collection. Results: From comparisons of highest and lowest (reference) quartiles, we observed statistically significant positive associations with risk of breast cancer for circulating levels of estradiol (multivariate relative risk [RR] = 1.91; 95% confidence interval [CI] = 1.06-3.46), estrone (multivariate RR = 1.96; 95% CI = 1.05-3.65), estrone sulfate (multivariate RR = 2.25; 95% CI = 1.23- 4.12), and dehydroepiandrosterone sulfate (multivariate RR = 2.15; 95% CI = 1.11-4.17). We found no substantial associations with percent free or percent bioavailable estradiol, androstenedione, testosterone, or dehydroepiandrosterone. The positive relationships were substantially stronger among women with no previous hormone replacement therapy. Conclusion: Our data, in conjunction with past epidemiologic and animal studies, provide strong evidence for a causal relationship between postmenopausal estrogen levels and the risk of breast cancer.
引用
收藏
页码:1292 / 1299
页数:8
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