The role of endogenous androgens and sex hormone-binding globulin (SHBG) in ovarian carcinogenesis is poorly understood. Epithelial invasive ovarian cancer (EOC) is a heterogeneous disease and there are no prospective data on endogenous androgens and EOC risk by tumor characteristics (histology, grade, stage) or the dualistic model of ovarian carcinogenesis (i.e. type I vs. type II, leading to less or more aggressive tumors). We conducted a nested case-control study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort evaluating androgens and SHBG and invasive EOC risk by tumor characteristics. Female participants who provided a blood sample and were not using exogenous hormones at blood donation were eligible (n = 183,257). A total of 565 eligible women developed EOC; two controls (n = 1,097) were matched per case. We used multivariable conditional logistic regression models. We observed no association between androgens, SHBG and EOC overall. A doubling of androstenedione reduced risk of serous carcinomas by 21% (odds ratio (OR)log2 = 0.79, 95% confidence interval [CI] = [0.64-0.97]). Moreover, associations differed for low-grade and high-grade carcinomas, with positive associations for low-grade and inverse associations for high-grade carcinomas (e.g. androstenedione: low grade: ORlog2 = 1.99 [0.98-4.06]; high grade: ORlog2 = 0.75 [0.61-0.93], phet ≤ 0.01), similar associations were observed for type I/II tumors. This is the first prospective study to evaluate androgens, SHBG and EOC risk by tumor characteristics and type I/II status. Our findings support a possible role of androgens in ovarian carcinogenesis. Additional studies exploring this association are needed.

Original publication

DOI

10.1002/ijc.29000

Type

Journal article

Journal

Int J Cancer

Publication Date

15/01/2015

Volume

136

Pages

399 - 410

Keywords

androstenedione, endogenous androgens, histologic subtype, ovarian carcinoma, type I tumors, type II tumors, Adult, Aged, Aged, 80 and over, Androgens, Case-Control Studies, Cystadenocarcinoma, Serous, Europe, Fallopian Tube Neoplasms, Female, Follow-Up Studies, Humans, Middle Aged, Neoplasm Grading, Neoplasm Invasiveness, Neoplasm Staging, Neoplasms, Glandular and Epithelial, Nutritional Status, Ovarian Neoplasms, Peritoneal Neoplasms, Prognosis, Prospective Studies, Risk Factors, Sex Hormone-Binding Globulin