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Urinary hydroxyestrogens and breast cancer risk among postmenopausal women: a prospective study.
Cancer Epidemiol Biomarkers Prev. 2005 Sep; 14(9):2137-42.CE

Abstract

BACKGROUND

It has been suggested that a low level of the 2-hydroxyestrogen metabolites (2-OHE) and a high level of 16alpha-hydroxyestrone (16alpha-OHE1) are associated with an enhanced risk of breast cancer. We examined the association between the metabolite levels and breast cancer in a nested case-control study, which also addressed hormone replacement therapy (HRT) and estrogen receptor status of the tumors.

METHODS

24,697 postmenopausal Danish women were enrolled in the "Diet, Cancer and Health" cohort. During follow-up, 426 breast cancer cases were identified and controls were matched by age at diagnosis, baseline age, and HRT use. The concentrations of 2-OHE and 16alpha-OHE1 in spot urine were measured by an enzyme immunoassay. Incidence rate ratios (IRR) and 95% confidence intervals (95% CI) were estimated for total and estrogen receptor-specific breast cancer and were stratified according to HRT use.

RESULTS

A higher incidence of estrogen receptor-positive breast cancer with an enhanced 2-OHE level was observed among current HRT users, IRR per doubling = 1.30 (95% CI, 1.02-1.66), whereas no association was seen among nonusers of HRT, IRR per doubling = 1.00 (95% CI, 0.69-1.45). The association between estrogen receptor-positive breast cancer and the 16alpha-OHE1 metabolite level was in the opposite direction but slightly weaker and statistically insignificant. For estrogen receptor-negative breast cancer, no significant associations were seen.

CONCLUSIONS

The risk of breast cancer, in particular the estrogen receptor-positive type, was enhanced among postmenopausal women using estradiol-based HRT and among those who had a high 2-OHE concentration.

Authors+Show Affiliations

Institute of Public Health, University of Copenhagen, Denmark.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16172222

Citation

Wellejus, Anja, et al. "Urinary Hydroxyestrogens and Breast Cancer Risk Among Postmenopausal Women: a Prospective Study." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 14, no. 9, 2005, pp. 2137-42.
Wellejus A, Olsen A, Tjonneland A, et al. Urinary hydroxyestrogens and breast cancer risk among postmenopausal women: a prospective study. Cancer Epidemiol Biomarkers Prev. 2005;14(9):2137-42.
Wellejus, A., Olsen, A., Tjonneland, A., Thomsen, B. L., Overvad, K., & Loft, S. (2005). Urinary hydroxyestrogens and breast cancer risk among postmenopausal women: a prospective study. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 14(9), 2137-42.
Wellejus A, et al. Urinary Hydroxyestrogens and Breast Cancer Risk Among Postmenopausal Women: a Prospective Study. Cancer Epidemiol Biomarkers Prev. 2005;14(9):2137-42. PubMed PMID: 16172222.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urinary hydroxyestrogens and breast cancer risk among postmenopausal women: a prospective study. AU - Wellejus,Anja, AU - Olsen,Anja, AU - Tjonneland,Anne, AU - Thomsen,Birthe L, AU - Overvad,Kim, AU - Loft,Steffen, PY - 2005/9/21/pubmed PY - 2005/12/13/medline PY - 2005/9/21/entrez SP - 2137 EP - 42 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 14 IS - 9 N2 - BACKGROUND: It has been suggested that a low level of the 2-hydroxyestrogen metabolites (2-OHE) and a high level of 16alpha-hydroxyestrone (16alpha-OHE1) are associated with an enhanced risk of breast cancer. We examined the association between the metabolite levels and breast cancer in a nested case-control study, which also addressed hormone replacement therapy (HRT) and estrogen receptor status of the tumors. METHODS: 24,697 postmenopausal Danish women were enrolled in the "Diet, Cancer and Health" cohort. During follow-up, 426 breast cancer cases were identified and controls were matched by age at diagnosis, baseline age, and HRT use. The concentrations of 2-OHE and 16alpha-OHE1 in spot urine were measured by an enzyme immunoassay. Incidence rate ratios (IRR) and 95% confidence intervals (95% CI) were estimated for total and estrogen receptor-specific breast cancer and were stratified according to HRT use. RESULTS: A higher incidence of estrogen receptor-positive breast cancer with an enhanced 2-OHE level was observed among current HRT users, IRR per doubling = 1.30 (95% CI, 1.02-1.66), whereas no association was seen among nonusers of HRT, IRR per doubling = 1.00 (95% CI, 0.69-1.45). The association between estrogen receptor-positive breast cancer and the 16alpha-OHE1 metabolite level was in the opposite direction but slightly weaker and statistically insignificant. For estrogen receptor-negative breast cancer, no significant associations were seen. CONCLUSIONS: The risk of breast cancer, in particular the estrogen receptor-positive type, was enhanced among postmenopausal women using estradiol-based HRT and among those who had a high 2-OHE concentration. SN - 1055-9965 UR - https://www.unboundmedicine.com/medline/citation/16172222/Urinary_hydroxyestrogens_and_breast_cancer_risk_among_postmenopausal_women:_a_prospective_study_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=16172222 DB - PRIME DP - Unbound Medicine ER -