@article{3151550,
    title = "Endogenous Sex Steroids and Risk of Cervical Carcinoma: Results from the
EPIC Study",
    author = "Rinaldi, Sabina and Plummer, Martyn and Biessy, Carine and Castellsague, and Xavier and Overvad, Kim and Kjaer, Susanne Krueger and Tjonneland, Anne and and Clavel-Chapelon, Francoise and Chabbert-Buffet, Nathalie and and Mesrine, Sylvie and Lukanova, Annekatrin and Kaaks, Rudolf and Weikert, and Cornelia and Boeing, Heiner and Trichopoulou, Antonia and Lagiou, Pagona and and Trichopoulos, Dimitrios and Palli, Domenico and Agnoli, Claudia and and Tumino, Rosario and Vineis, Paolo and Panico, Salvatore and and Bueno-de-Mesquita, Bas and van Kranen, Henk J. and Peeters, Petra H. M. and and Bakken, Kjersti and Lund, Eiliv and Gram, Inger Torhild and and Rodriguez, Laudina and Bosch, F. Xavier and Sanchez, Maria-Jose and and Dorronsoro, Miren and Navarro, Carmen and Barricarte Gurrea, Aurelio and and Kjellberg, Lennart and Dillner, Joakim and Manjer, Jonas and Butt, Salma and and Khaw, Kay-Tee and Wareham, Nicholas and Allen, Naomi E. and Travis, and Ruth and Romieu, Isabelle and Ferrari, Pietro and Riboli, Elio and and Franceschi, Silvia",
    journal = "Cancer Epidemiology, Biomarkers & Prevention",
    year = "2011",
    volume = "20",
    number = "12",
    pages = "2532-2540",
    publisher = "AMER ASSOC CANCER RESEARCH",
    issn = "1055-9965, 1538-7755",
    doi = "10.1158/1055-9965.EPI-11-0753",
    abstract = "Background: Epidemiologic data and animal models suggest that, despite
the predominant role of human papillomavirus infection, sex steroid
hormones are also involved in the etiology of invasive cervical
carcinoma (ICC).
Methods: Ninety-nine ICC cases, 121 cervical intraepithelial neoplasia
grade 3 (CIN3) cases and 2 control women matched with each case for
center, age, menopausal status and blood collection-related variables,
were identified in the European Prospective Investigation into Cancer
and Nutrition (EPIC) study. Circulating levels of testosterone (T) and
estradiol (E-2); dehydroepiandrosterone sulfate (DHEAS); progesterone
(premenopausal women); and sex hormone-binding globulin (SHBG) were
measured using immunoassays. Levels of free (f) T and E-2 were
calculated from absolute concentrations of T, E-2, and SHBG. Odds ratios
(ORs) and 95% confidence intervals (CI) were computed using regularized
conditional logistic regression.
Results: Among premenopausal women, associations with ICC were observed
for fT (OR for highest vs. lowest tertile 5.16, 95% CI, 1.50-20.1).
SHBG level was associated with a significant downward trend in ICC risk.
T, E-2, fE(2), and DHEAS showed nonsignificant positive association with
ICC. Progesterone was uninfluential. Among postmenopausal women,
associations with ICC were found for T (OR 3.14; 95% CI, 1.21-9.37),
whereas E-2 and fT showed nonsignificant positive association. SHBG
level was unrelated to ICC risk in postmenopausal women. No associations
between any hormone and CIN3 were detected in either pre- or
postmenopausal women.
Conclusions: Our findings suggest for the first time that T and possibly
E-2 may be involved in the etiology of ICC.
Impact: The responsiveness of cervical tumors to hormone modulators is
worth exploring. Cancer Epidemiol Biomarkers Prev; 20(12); 2532-40. (C)
2011 AACR."
}