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American Journal of Epidemiology Advance Access published online on November 3, 2007
American Journal of Epidemiology, doi:10.1093/aje/kwm278
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Original Contribution

Plasma Androgen Concentrations and Risk of Incident Ovarian Cancer

Shelley S. Tworoger1,2, I-Min Lee2,3, Julie E. Buring2,3 and Susan E. Hankinson1,2

1 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
2 Department of Epidemiology, Harvard School of Public Health, Boston, MA
3 Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA

Correspondence to Dr. Shelley S. Tworoger, Channing Laboratory, 181 Longwood Avenue, 3rd Floor, Boston, MA 02115 (e-mail: nhsst{at}channing.harvard.edu).

Received for publication May 29, 2007. Accepted for publication August 27, 2007.

Androgens have been implicated in increasing ovarian cancer risk; however, results from prospective studies have been inconclusive. The authors examined whether plasma concentrations of testosterone, androstenedione, dehydroepiandrosterone, and dehydroepiandrosterone sulfate were associated with risk of epithelial ovarian cancer in a nested-case control study, using data from three prospective cohort studies: the Nurses' Health Study (NHS), Nurses' Health Study II (NHSII), and the Women's Health Study (WHS). The present analysis comprised 224 cases (161 from the NHS/NHSII and 63 from the WHS) and 603 controls (matched at a ratio of 1:3 for the NHS/NHSII and 1:2 for the WHS), with follow-up of up to 14 years. Women ranged in age from 34 years to 72 years (mean age = 56 years). The authors did not observe any associations between plasma androgen levels and risk of ovarian cancer. For example, comparing the top quartile with the bottom quartile, the relative risk was 0.74 (95% confidence interval: 0.44, 1.25; p-trend = 0.34) for testosterone and 0.76 (95% confidence interval: 0.45, 1.30; p-trend = 0.65) for androstenedione. There was a suggestion that dehydroepiandrosterone and dehydroepiandrosterone sulfate were inversely associated with ovarian cancer risk among postmenopausal women (for top quartile vs. bottom, relative risks were 0.65 and 0.70, respectively). Overall, these results do not support a positive association between circulating androgen levels and ovarian cancer risk.

androgens; androstenedione; dehydroepiandrosterone; dehydroepiandrosterone sulfate; ovarian neoplasms; prospective studies; testosterone

Abbreviations: CI, confidence interval; DHEA, dehydroepiandrosterone; DHEAS, dehydroepiandrosterone sulfate; EDTA, ethylenediaminetetraacetic acid; NHS, Nurses' Health Study; NHSII, Nurses' Health Study II; WHS, Women's Health Study


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