Circulating Sex Hormones Are Associated With Gastric and Colorectal Cancers but Not Esophageal Adenocarcinoma in the UK Biobank.

Gastrointestinal cancers show an unexplained male predominance, but few prospective studies have investigated sex hormones and gastrointestinal cancer risk. To determine the impact of circulating sex hormones on risk of esophageal, gastric and colorectal cancer in men and women. We included 219,425 men and 147,180 women from UK Biobank. Sex hormones were quantified using chemiluminescent immunoassay. Gastrointestinal cancers were identified from cancer registry linkages. Sex hormone concentrations and risk of gastrointestinal cancers were investigated using Cox proportional hazards regression. During 10 years of follow-up, 376 esophageal adenocarcinoma, 108 esophageal squamous cell carcinoma, 333 gastric and 2,868 colorectal cancer cases were identified. Increased hazard ratios (HRs) were found for sex hormone-binding globulin (SHBG) and risk of gastric cancer in men (Q4 v. Q1 HR 1.43, 95% CI 0.95, 2.17, Ptrend=0.01). Free testosterone was inversely associated with esophageal squamous cell carcinoma in women (Q4 v. Q1 HR 0.32, 95% CI 0.11, 0.98, Ptrend=0.05). For colorectal cancer, SHBG was associated with a reduced risk among men (Q4 v. Q1 HR 0.89, 95% CI 0.77, 1.03, Ptrend=0.04) and free testosterone concentrations a reduction in risk among women (Q4 v. Q1 HR 0.80, 95% CI 0.66, 0.97, Ptrend=0.01). No associations were found for esophageal adenocarcinoma. In this large prospective investigation of prediagnostic sex hormones and risk of gastrointestinal cancers, men with higher SHBG concentrations had higher gastric, yet lower colorectal, cancer risks while women with higher free testosterone levels had lower risk of esophageal squamous cell carcinoma and colorectal cancer.

胃肠道癌症呈现出一种原因不明的男性居多的情况，但很少有前瞻性研究调查性激素与胃肠道癌症风险的关系。 为了确定循环性激素对男性和女性患食管癌、胃癌和结直肠癌风险的影响。 我们纳入了来自英国生物银行的219425名男性和147180名女性。使用化学发光免疫分析法对性激素进行定量。通过癌症登记关联确定胃肠道癌症。使用考克斯比例风险回归模型研究性激素浓度与胃肠道癌症风险的关系。 在10年的随访期间，确定了376例食管腺癌、108例食管鳞状细胞癌、333例胃癌和2868例结直肠癌病例。在男性中发现性激素结合球蛋白（SHBG）与胃癌风险的风险比（HR）升高（第四四分位数与第一四分位数相比，HR为1.43，95%置信区间为0.95 - 2.17，趋势P值 = 0.01）。在女性中，游离睾酮与食管鳞状细胞癌呈负相关（第四四分位数与第一四分位数相比，HR为0.32，95%置信区间为0.11 - 0.98，趋势P值 = 0.05）。对于结直肠癌，在男性中SHBG与风险降低相关（第四四分位数与第一四分位数相比，HR为0.89，95%置信区间为0.77 - 1.03，趋势P值 = 0.04），在女性中游离睾酮浓度与风险降低相关（第四四分位数与第一四分位数相比，HR为0.80，95%置信区间为0.66 - 0.97，趋势P值 = 0.01）。未发现与食管腺癌有关联。 在这项针对诊断前性激素与胃肠道癌症风险的大型前瞻性调查中，SHBG浓度较高的男性患胃癌的风险较高，但患结直肠癌的风险较低，而游离睾酮水平较高的女性患食管鳞状细胞癌和结直肠癌的风险较低。