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Petrick JL, Florio AA, Zhang X, Zeleniuch-Jacquotte A, Wactawski-Wende J, Van Den Eeden SK, Stanczyk FZ, Simon TG, Sinha R, Sesso HD, Schairer C, Rosenberg L, Rohan TE, Purdue MP, Palmer JR, Linet MS, Liao LM, Lee IM, Koshiol J, Kitahara CM, Kirsh VA, Hofmann JN, Guillemette C, Graubard BI, Giovannucci E, Gaziano JM, Gapster SM, Freedman ND, Engel LS, Chong DQ, Chen Y, Chan AT, Caron P, Buring JE, Bradwin G, Beane Freeman LE, Campbell PT, McGlynn KA. Associations Between Prediagnostic Concentrations of Circulating Sex Steroid Hormones and Liver Cancer Among Postmenopausal Women. Hepatology 2020; 72:535-547. [PMID: 31808181 PMCID: PMC7391790 DOI: 10.1002/hep.31057] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 11/25/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS In almost all countries, incidence rates of liver cancer (LC) are 100%-200% higher in males than in females. However, this difference is predominantly driven by hepatocellular carcinoma (HCC), which accounts for 75% of LC cases. Intrahepatic cholangiocarcinoma (ICC) accounts for 12% of cases and has rates only 30% higher in males. Hormones are hypothesized to underlie observed sex differences. We investigated whether prediagnostic circulating hormone and sex hormone binding globulin (SHBG) levels were associated with LC risk, overall and by histology, by leveraging resources from five prospective cohorts. APPROACH AND RESULTS Seven sex steroid hormones and SHBG were quantitated using gas chromatography/tandem mass spectrometry and competitive electrochemiluminescence immunoassay, respectively, from baseline serum/plasma samples of 191 postmenopausal female LC cases (HCC, n = 83; ICC, n = 56) and 426 controls, matched on sex, cohort, age, race/ethnicity, and blood collection date. Odds ratios (ORs) and 95% confidence intervals (CIs) for associations between a one-unit increase in log2 hormone value (approximate doubling of circulating concentration) and LC were calculated using multivariable-adjusted conditional logistic regression. A doubling in the concentration of 4-androstenedione (4-dione) was associated with a 50% decreased LC risk (OR = 0.50; 95% CI = 0.30-0.82), whereas SHBG was associated with a 31% increased risk (OR = 1.31; 95% CI = 1.05-1.63). Examining histology, a doubling of estradiol was associated with a 40% increased risk of ICC (OR = 1.40; 95% CI = 1.05-1.89), but not HCC (OR = 1.12; 95% CI = 0.81-1.54). CONCLUSIONS This study provides evidence that higher levels of 4-dione may be associated with lower, and SHBG with higher, LC risk in women. However, this study does not support the hypothesis that higher estrogen levels decrease LC risk. Indeed, estradiol may be associated with an increased ICC risk.
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Affiliation(s)
- Jessica L. Petrick
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD,,Slone Epidemiology Center, Boston University, Boston, MA
| | - Andrea A. Florio
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Xuehong Zhang
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health, New York University School of Medicine, New York, NY,,NYU Perlmutter Cancer Center, New York University School of Medicine, New York, NY
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY
| | | | - Frank Z. Stanczyk
- Departments of Obstetrics and Gynecology and Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Tracey G. Simon
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Howard D. Sesso
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,,Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Catherine Schairer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Lynn Rosenberg
- Slone Epidemiology Center, Boston University, Boston, MA
| | - Thomas E. Rohan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Mark P. Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | - Martha S. Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Linda M. Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - I-Min Lee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,,Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Victoria A. Kirsh
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan N. Hofmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Chantal Guillemette
- Pharmacogenomics Laboratory, Centre Hospitalier Universitaire de Québec - (CHU de Québec) Research Center - Université Laval and Faculty of Pharmacy, Laval University, Québec, Canada
| | - Barry I. Graubard
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Edward Giovannucci
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - J. Michael Gaziano
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA,,VA Boston Healthcare System, Boston, MA
| | - Susan M. Gapster
- Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Neal D. Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Lawrence S. Engel
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC
| | - Dawn Q. Chong
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Yu Chen
- Department of Population Health, New York University School of Medicine, New York, NY,,Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | - Andrew T. Chan
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA,,Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA,,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA
| | - Patrick Caron
- Pharmacogenomics Laboratory, Centre Hospitalier Universitaire de Québec - (CHU de Québec) Research Center - Université Laval and Faculty of Pharmacy, Laval University, Québec, Canada
| | - Julie E. Buring
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,,Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Gary Bradwin
- Clinical and Epidemiologic Research Laboratory, Department of Laboratory Medicine, Boston Children’s Hospital, Boston, MA
| | | | | | - Katherine A. McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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