DO URINARY ESTROGEN METABOLITES PREDICT BREAST-CANCER - GUERNSEY-III COHORT FOLLOW-UP

Citation
En. Meilahn et al., DO URINARY ESTROGEN METABOLITES PREDICT BREAST-CANCER - GUERNSEY-III COHORT FOLLOW-UP, British Journal of Cancer, 78(9), 1998, pp. 1250-1255
Citations number
26
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology
Journal title
ISSN journal
0007-0920
Volume
78
Issue
9
Year of publication
1998
Pages
1250 - 1255
Database
ISI
SICI code
0007-0920(1998)78:9<1250:DUEMPB>2.0.ZU;2-V
Abstract
This is the first prospective study of urinary measures of the two maj or competing pathways of oestrogen metabolism, 16 alpha-hydroxyoestron e (16 alpha-OHE1) and 2-hydroxyoestrone (2-OHE1), in relation to incid ent breast cancer risk, Experimental and case-control study results su ggest that metabolism favouring the more oestrogenic 16 alpha-OHE1 pat hway may be linked to higher breast cancer risk. Women aged 35 and old er from Guernsey (n = 5104) were surveyed in 1977-85 and have been con tinuously monitored for breast cancer and mortality up to the present (Guernsey ill, Imperial Cancer Research Fund). Incident cases of breas t cancer were matched to three control subjects for comparison of urin ary oestrogen metabolite levels measured by enzyme immunoassay (EIA) i n spot urine samples collected at baseline and stored frozen for up to 19 years. Consistent with case-control study results, post-menopausal (but not premenopausal) women at baseline who went on to develop brea st cancer showed about a 15% lower 2:16 alpha-OHE1 ratio than matched control subjects. Further, subjects with metabolite ratios in the high est tertile of 2:16 alpha-OHE1 had about a 30% lower risk than women w ith ratios in the lowest two-thirds, although results were not statist ically significant (OR = 0.71, 95% CI = 0.29-1.75). It is of potential importance that, in contrast to most risk factors for breast cancer, such as late age at first birth, oestrogen metabolism appears to be mo difiable via diet and exercise, offering women the possibility of lowe ring breast cancer risk through non-pharmacological measures, although this remains to be tested.