Table 3.
Odds Ratios (ORs) and 95% Confidence Intervals (CIs) for risk of epithelial ovarian cancer overall and by subtypes for individual androgens/androgen metabolites and relevant ratios, nested case-control study within the WHI-OS.
| Tertile Median | Controls | Cases | All ovarian cancer cases | Serous | Non-Serous | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DHEA | n (%) | n (%) | ORa | 95% CI | n (%) | ORb | 95% CI | n (%) | ORb | 95% CI | P hetc | |
| Tertile (T)1 | 2.4 | 135 (32.8) | 50 (29.6) | 1.00 | 35 (34.3) | 1.00 | 15 (22.4) | 1.00 | 0.14 | |||
| T2 | 4.8 | 135 (32.8) | 65 (38.5) | 1.22 | (0.78, 1.91) | 41 (40.2) | 1.14 | (0.67, 1.92) | 24 (35.8) | 1.40 | (0.69, 2.83) | |
| T3 | 8.7 | 140 (34.0) | 54 (32.0) | 1.00 | (0.62, 1.62) | 26 (25.5) | 0.70 | (0.39, 1.26) | 28 (41.8) | 1.56 | (0.78, 3.14) | |
| DHEAS | ||||||||||||
| T1 | 518 | 135 (32.8) | 48 (28.4) | 1.00 | 37 (36.3) | 1.00 | 11 (16.4) | 1.00 | 0.05 | |||
| T2 | 1109 | 135 (32.8) | 67 (39.6) | 1.32 | (0.84, 2.08) | 37 (36.3) | 1.08 | (0.64, 1.84) | 30 (44.8) | 2.78 | (1.32, 5.87) | |
| T3 | 2045 | 140 (34.0) | 54 (32.0) | 1.00 | (0.62, 1.62) | 28 (27.5) | 0.74 | (0.42, 1.31) | 26 (38.8) | 1.97 | (0.91, 4.27) | |
| Androstenedione | ||||||||||||
| T1 | 0.8 | 134 (32.5) | 49 (29.0) | 1.00 | 36 (35.3) | 1.00 | 13 (19.4) | 1.00 | 0.09 | |||
| T2 | 1.3 | 136 (33.0) | 63 (37.3) | 1.29 | (0.82, 2.03) | 37 (36.3) | 1.08 | (0.64, 1.85) | 26 (38.8) | 1.91 | (0.92, 3.94) | |
| T3 | 2.0 | 140 (34.0) | 57 (33.7) | 1.12 | (0.70, 1.79) | 29 (28.4) | 0.78 | (0.45, 1.38) | 28 (41.8) | 1.86 | (0.91, 3.82) | |
| Testosterone | ||||||||||||
| T1 | 0.3 | 134 (32.5) | 47 (27.8) | 1.00 | 28 (27.5) | 1.00 | 19 (28.4) | 1.00 | 0.09 | |||
| T2 | 0.5 | 134 (32.5) | 57 (33.7) | 1.17 | (0.74, 1.84) | 40 (39.2) | 1.48 | (0.85, 2.57) | 17 (25.4) | 0.86 | (0.42, 1.75) | |
| T3 | 0.9 | 142 (34.5) | 65 (38.5) | 1.32 | (0.84, 2.07) | 34 (33.3) | 1.12 | (0.63, 1.99) | 31 (46.3) | 1.47 | (0.77, 2.79) | |
| 5α-androstanedione | ||||||||||||
| T1 | 0.8 | 135 (32.8) | 56 (33.1) | 1.00 | 33 (32.4) | 1.00 | 23 (34.3) | 1.00 | 0.57 | |||
| T2 | 1.2 | 134 (32.5) | 46 (27.2) | 0.83 | (0.52, 1.32) | 32 (31.4) | 0.97 | (0.56, 1.68) | 14 (20.9) | 0.60 | (0.29, 1.22) | |
| T3 | 2.0 | 141 (34.2) | 67 (39.6) | 1.19 | (0.77, 1.84) | 37 (36.3) | 1.18 | (0.69, 2.02) | 30 (44.8) | 1.37 | (0.74, 2.53) | |
| DHT | ||||||||||||
| T1 | 0.1 | 134 (32.5) | 56 (33.1) | 1.00 | 34 (33.3) | 1.00 | 22 (32.8) | 1.00 | 0.04 | |||
| T2 | 0.2 | 133 (32.3) | 59 (34.9) | 1.05 | (0.67, 1.63) | 29 (28.4) | 0.84 | (0.48, 1.47) | 30 (44.8) | 1.42 | (0.77, 2.63) | |
| T3 | 0.3 | 143 (34.7) | 54 (32.0) | 0.86 | (0.55, 1.35) | 39 (38.2) | 1.08 | (0.64, 1.83) | 15 (22.4) | 0.67 | (0.33, 1.35) | |
| DHTS | ||||||||||||
| T1 | 0.5 | 134 (32.5) | 50 (29.6) | 1.00 | 36 (35.3) | 1.00 | 14 (20.9) | 1.00 | 0.16 | |||
| T2 | 1.0 | 136 (33.0) | 54 (32.0) | 1.12 | (0.71, 1.77) | 30 (29.4) | 0.80 | (0.46, 1.40) | 24 (35.8) | 1.59 | (0.77, 3.25) | |
| T3 | 1.8 | 140 (34.0) | 65 (38.5) | 1.22 | (0.78, 1.91) | 36 (35.3) | 0.88 | (0.52, 1.51) | 29 (43.3) | 1.76 | (0.87, 3.55) | |
| Androsterone (ADT) | ||||||||||||
| T1 | 0.4 | 131 (31.8) | 62 (36.7) | 1.00 | 41 (40.2) | 1.00 | 21 (31.3) | 1.00 | 0.08 | |||
| T2 | 0.5 | 139 (33.7) | 51 (30.2) | 0.73 | (0.46, 1.14) | 25 (24.5) | 0.59 | (0.33, 1.03) | 26 (38.8) | 1.16 | (0.61, 2.21) | |
| T3 | 0.8 | 140 (34.0) | 56 (33.1) | 0.81 | (0.53, 1.25) | 36 (35.3) | 0.76 | (0.45, 1.28) | 20 (29.9) | 0.80 | (0.41, 1.57) | |
| ADT-G | ||||||||||||
| T1 | 8.8 | 135 (32.8) | 43 (25.4) | 1.00 | 37 (36.3) | 1.00 | 6 (9) | 1.00 | 0.002 | |||
| T2 | 18.9 | 135 (32.8) | 74 (43.8) | 1.65 | (1.04, 2.62) | 40 (39.2) | 1.15 | (0.68, 1.96) | 34 (50.7) | 5.97 | (2.37, 15.05) | |
| T3 | 42.6 | 140 (34.0) | 52 (30.8) | 1.06 | (0.64, 1.76) | 25 (24.5) | 0.68 | (0.37, 1.24) | 27 (40.3) | 4.36 | (1.68, 11.32) | |
| 3αdiol-3G | P trendd = 0.08 | |||||||||||
| T1 | 0.6 | 135 (32.8) | 59 (34.9) | 1.00 | 41 (40.2) | 1.00 | 18 (26.9) | 1.00 | 0.32 | |||
| T2 | 1.3 | 135 (32.8) | 55 (32.5) | 0.86 | (0.55, 1.35) | 32 (31.4) | 0.81 | (0.47, 1.39) | 23 (34.3) | 1.24 | (0.62, 2.47) | |
| T3 | 2.9 | 140 (34.0) | 55 (32.5) | 0.80 | (0.50, 1.28) | 29 (28.4) | 0.70 | (0.39, 1.23) | 26 (38.8) | 1.31 | (0.66, 2.63) | |
| 3αdiol-17G | ||||||||||||
| T1 | 0.6 | 135 (32.8) | 50 (29.6) | 1.00 | 31 (30.4) | 1.00 | 19 (28.4) | 1.00 | 0.05 | |||
| T2 | 1.2 | 135 (32.8) | 67 (39.6) | 1.24 | (0.78, 1.96) | 46 (45.1) | 1.49 | (0.87, 2.56) | 21 (31.3) | 0.96 | (0.48, 1.92) | |
| T3 | 2.3 | 140 (34.0) | 52 (30.8) | 0.89 | (0.55, 1.45) | 25 (24.5) | 0.78 | (0.42, 1.43) | 27 (40.3) | 1.17 | (0.60, 2.29) | |
| Total 5α-reduced glucuronide metabolites (Σ(ADT-G, 3αdiol-3G, 3αdiol-17G)) | ||||||||||||
| T1 | 10.4 | 135 (32.8) | 45 (26.6) | 1.00 | 38 (37.3) | 1.00 | 7 (10.4) | 1.00 | 0.002 | |||
| T2 | 21.8 | 135 (32.8) | 73 (43.2) | 1.54 | (0.98, 2.44) | 40 (39.2) | 1.09 | (0.64, 1.85) | 33 (49.3) | 4.99 | (2.07, 11.98) | |
| T3 | 47.6 | 140 (34.0) | 51 (30.2) | 1.00 | (0.60, 1.65) | 24 (23.5) | 0.61 | (0.34, 1.12) | 27 (40.3) | 3.63 | (1.47, 8.95) | |
| Etiocholanolone-glucuronide | ||||||||||||
| T1 | 15.9 | 135 (32.8) | 62 (36.7) | 1.00 | 41 (40.2) | 1.00 | 21 (31.3) | 1.00 | 0.25 | |||
| T2 | 31.6 | 135 (32.8) | 50 (29.6) | 0.75 | (0.48, 1.17) | 31 (30.4) | 0.81 | (0.47, 1.38) | 19 (28.4) | 0.93 | (0.47, 1.84) | |
| T3 | 63.6 | 140 (34.0) | 57 (33.7) | 0.84 | (0.54, 1.32) | 30 (29.4) | 0.77 | (0.44, 1.32) | 27 (40.3) | 1.32 | (0.69, 2.50) | |
| Unconjugated Estrone | P trendd = 0.10 | |||||||||||
| T1 | 35.2 | 135 (32.8) | 51 (30.2) | 1.00 | 35 (34.3) | 1.00 | 16 (23.9) | 1.00 | 0.04 | |||
| T2 | 55.0 | 136 (33.0) | 53 (31.4) | 0.95 | (0.59, 1.52) | 35 (34.3) | 0.92 | (0.54, 1.59) | 18 (26.9) | 0.96 | (0.46, 2.00) | |
| T3 | 90.4 | 140 (34.0) | 64 (37.9) | 1.06 | (0.65, 1.75) | 31 (30.4) | 0.71 | (0.39, 1.29) | 33 (49.3) | 1.79 | (0.88, 3.62) | |
| Unconjugated Estradiol | ||||||||||||
| T1 | 5.0 | 135 (32.8) | 50 (29.6) | 1.00 | 37 (36.3) | 1.00 | 13 (19.4) | 1.00 | 0.01 | |||
| T2 | 11.6 | 136 (33.0) | 52 (30.8) | 0.96 | (0.60, 1.55) | 32 (31.4) | 0.83 | (0.47, 1.44) | 20 (29.9) | 1.54 | (0.72, 3.31) | |
| T3 | 27.1 | 140 (34.0) | 66 (39.1) | 1.09 | (0.65, 1.84) | 32 (31.4) | 0.68 | (0.36, 1.27) | 34 (50.7) | 2.57 | (1.18, 5.60) | |
| Unconjugated estradiol/Androstenedione | ||||||||||||
| T1 | 3.9 | 135 (32.8) | 51 (30.2) | 1.00 | 39 (38.2) | 1.00 | 12 (17.9) | 1.00 | 0.01 | |||
| T2 | 8.5 | 135 (32.8) | 54 (32.0) | 0.99 | (0.61, 1.59) | 27 (26.5) | 0.67 | (0.38, 1.20) | 27 (40.3) | 2.41 | (1.13, 5.13) | |
| T3 | 20.7 | 140 (34.0) | 63 (37.3) | 1.06 | (0.64, 1.76) | 35 (34.3) | 0.78 | (0.43, 1.42) | 28 (41.8) | 2.30 | (1.03, 5.13) | |
| Unconjugated estradiol/Testosterone | ||||||||||||
| T1 | 9.9 | 135 (32.8) | 58 (34.3) | 1.00 | 43 (42.2) | 1.00 | 15 (22.4) | 1.00 | 0.02 | |||
| T2 | 19.7 | 135 (32.8) | 50 (29.6) | 0.76 | (0.47, 1.23) | 25 (24.5) | 0.54 | (0.30, 0.96) | 25 (37.3) | 1.55 | (0.75, 3.18) | |
| T3 | 46.3 | 140 (34.0) | 60 (35.5) | 0.77 | (0.45, 1.32) | 33 (32.4) | 0.60 | (0.32, 1.13) | 27 (40.3) | 1.66 | (0.75, 3.66) | |
a
OR from conditional logistic model, conditioned on matching factors (age at baseline, year of blood draw, race/ethnicity, hysterectomy status, and time since last menopausal hormone use) and additionally adjusted for body mass index, smoking status, gravidity, and duration of oral contraceptive use.
b
OR from model adjusting for matching factors (age at baseline, year of blood draw, race/ethnicity, hysterectomy status, and time since last menopausal hormone use), and body mass index, smoking status, gravidity, and duration of oral contraceptive use.
c
P heterogeneity
d
P values for trend across tertile (median value of category), all other P trend>0.10