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Do sex hormones underlie sex differences in cancer incidence? Testing the intuitive in esophageal adenocarcinoma
- Source :
- Am J Gastroenterol
- Publication Year :
- 2020
-
Abstract
- Sex hormones have been hypothesized to explain the strong male predominance in esophageal adenocarcinoma, but evidence is needed. This study examined how circulating sex hormone levels influence future risk of esophageal adenocarcinoma.This case-control study was nested in a prospective Norwegian cohort (Janus Serum Bank Cohort), including 244 male patients with esophageal adenocarcinoma and 244 male age-matched control participants. Associations between prediagnostic circulating levels of 12 sex hormones and risk of esophageal adenocarcinoma were assessed using conditional logistic regression. In addition, a random-effect meta-analysis combined these data with a similar prospective study for 5 sex hormones.Decreased odds ratios (ORs) of esophageal adenocarcinoma were found comparing the highest with lowest quartiles of testosterone (OR = 0.44, 95% confidence interval [CI] 0.22-0.88), testosterone:estradiol ratio (OR = 0.37, 95% CI 0.19-0.72), and luteinizing hormone (OR = 0.50, 95% CI 0.30-0.98), after adjustment for tobacco smoking and physical activity. These associations were attenuated after further adjustment for body mass index (OR = 0.56, 95% CI 0.27-1.13 for testosterone; OR = 0.46, 95% CI 0.23-0.91 for testosterone:estradiol ratio; OR = 0.55, 95% CI 0.29-1.08 for luteinizing hormone). No associations were observed for sex hormone-binding globulin, dehydroepiandrosterone sulfate, follicle-stimulating hormone, prolactin, 17-OH progesterone, progesterone, androstenedione, or free testosterone index. The meta-analysis showed an inverse association between testosterone levels and risk of esophageal adenocarcinoma (pooled OR for the highest vs lowest quartile = 0.60, 95% CI 0.38-0.97), whereas no associations were identified for androstenedione, sex hormone-binding globulin, estradiol, or testosterone:estradiol ratio.Higher circulating testosterone levels may decrease the risk of esophageal adenocarcinoma in men.
- Subjects :
- Adult
Male
Esophageal Neoplasms
Physiology
Esophageal adenocarcinoma
Adenocarcinoma
Article
03 medical and health sciences
0302 clinical medicine
Risk Factors
Sex Hormone-Binding Globulin
Medicine
Humans
Testosterone
Prospective Studies
Prospective cohort study
Gonadal Steroid Hormones
Progesterone
Hepatology
Estradiol
business.industry
Dehydroepiandrosterone Sulfate
Norway
Incidence
Incidence (epidemiology)
17-alpha-Hydroxyprogesterone
Gastroenterology
Androstenedione
Luteinizing Hormone
Middle Aged
medicine.disease
Prolactin
Logistic Models
Cancer incidence
030220 oncology & carcinogenesis
Case-Control Studies
Gonadotropins, Pituitary
Female
030211 gastroenterology & hepatology
Follicle Stimulating Hormone
business
Luteinizing hormone
Hormone
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Am J Gastroenterol
- Accession number :
- edsair.doi.dedup.....d4dafd89ee4fe08a36f463fea05254fd