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. Author manuscript; available in PMC: 2021 Feb 19.
Published in final edited form as: Int J Cancer. 2020 Jan 11;147(4):920–930. doi: 10.1002/ijc.32844

Table 4.

Multivariable hazard ratios of death according to tertiles of prediagnostic hormone levels in women

Overall mortality (n = 106)
 CRC mortality (n = 70)
Tertile 1 Tertile 2 Tertile 3 ptrend Tertile 1 Tertile 2 Tertile 3 ptrend
Estradiol
 Model 11 Referent 1.03 (0.63–1.68) 1.20 (0.75–1.94) 0.42 Referent 1.37 (0.75–2.51) 1.53 (0.83–2.81) 0.21
 Model 1 + BMI + PA2 Referent 1.08 (0.66–1.77) 1.49 (0.81–2.73) 0.18 Referent 1.48 (0.80–2.76) 2.04 (0.96–4.37) 0.08
 Model 1 + BMI + PA + C-peptide3 Referent 1.03 (0.62–1.71) 1.45 (0.79–2.66) 0.20 Referent 1.49 (0.78–2.83) 2.00 (0.92–4.35) 0.10
Estrone
 Model 11 Referent 1.22 (0.74–2.03) 1.35 (0.85–2.15) 0.22 Referent 2.12 (1.11–4.05) 1.76 (0.97–3.21) 0.09
 Model 1 + BMI+PA2 Referent 1.29 (0.78–2.16) 1.54 (0.92–2.61) 0.10 Referent 2.18 (1.14–4.20) 2.00 (1.03–3.91) 0.048
 Model 1 + BMI + PA + C-peptide3 Referent 1.30 (0.78–2.18) 1.54 (0.92–2.60) 0.11 Referent 2.26 (1.17–4.37) 1.96 (1.01–3.84) 0.06
Free estradiol
 Model 11 Referent 0.98 (0.60–1.60) 1.19 (0.74–1.92) 0.41 Referent 1.03 (0.57–1.88) 1.31 (0.72–2.38) 0.35
 Model 1 + BMI + PA2 Referent 1.05 (0.63–1.75) 1.49 (0.80–2.77) 0.19 Referent 1.11 (0.59–2.07) 1.69 (0.79–3.60) 0.16
 Model 1 + BMI + PA + C-peptide3 Referent 1.01 (0.60–1.70) 1.43 (0.77–2.67) 0.22 Referent 1.11 (0.58–2.10) 1.67 (0.76–3.64) 0.18
Testosterone
 Model 11 Referent 1.04 (0.64–1.69) 0.96 (0.60–1.53) 0.85 Referent 1.35 (0.73–2.49) 1.27 (0.71–2.27) 0.47
 Model 1 + BMI + PA2 Referent 1.08 (0.66–1.77) 1.01 (0.63–1.61) 0.99 Referent 1.37 (0.74–2.55) 1.27 (0.71–2.30) 0.47
 Model 1 + BMI + PA + C-peptide3 Referent 1.08 (0.66–1.77) 1.02 (0.64–1.64) 0.94 Referent 1.41 (0.76–2.62) 1.29 (0.71–2.35) 0.45
Free testosterone
 Model 11 Referent 1.17 (0.72–1.90) 1.20 (0.72–2.01) 0.52 Referent 1.02 (0.55–1.91) 1.41 (0.76–2.61) 0.25
 Model 1 + BMI + PA2 Referent 1.21 (0.75–1.97) 1.24 (0.73–2.11) 0.47 Referent 1.04 (0.56–1.95) 1.47 (0.78–2.75) 0.21
 Model 1 + BMI + PA + C-peptide3 Referent 1.19 (0.72–1.95) 1.23 (0.72–2.11) 0.49 Referent 1.09 (0.57–2.07) 1.50 (0.79–2.85) 0.19
The ratio of estradiol to testosterone
 Model 11 Referent 0.88 (0.54–1.44) 1.06 (0.67–1.70) 0.71 Referent 0.71 (0.39–1.30) 0.96 (0.54–1.69) 0.99
 Model 1 + BMI + PA2 Referent 0.94 (0.56–1.56) 1.16 (0.65–2.05) 0.57 Referent 0.74 (0.39–1.40) 1.05 (0.51–2.20) 0.82
 Model 1 + BMI + PA + C-peptide3 Referent 0.92 (0.55–1.53) 1.11 (0.62–1.99) 0.68 Referent 0.74 (0.39–1.41) 0.97 (0.46–2.06) 0.99
SHBG
 Model 11 Referent 1.42 (0.85–2.37) 1.15 (0.65–2.03) 0.88 Referent 1.52 (0.80–2.89) 1.45 (0.73–2.90) 0.40
 Model 1 + BMI + PA2 Referent 1.44 (0.85–2.43) 1.13 (0.60–2.14) 0.98 Referent 1.54 (0.79–3.00) 1.50 (0.70–3.21) 0.43
 Model 1 + BMI + PA + C-peptide3 Referent 1.45 (0.86–2.45) 1.20 (0.63–2.28) 0.80 Referent 1.57 (0.81–3.07) 1.62 (0.75–3.52) 0.31

Twenty-three patients had missing value for plasma C-peptide levels. The values were replaced by the median. The tertile categories for estradiol, estrone, testosterone and SHBG in women were shown in Table 1 footnote. The tertile categories in women were <0.05, 0.05–0.11, ≥0.11 pg/ml for free estradiol, <0.17, 0.17–0.29, ≥0.29 ng/dl for free testosterone and <0.022, 0.022–0.035, ≥0.035 (pg/ml)/(ng/dl) for the ratio of estradiol to testosterone.

1

Adjusted for age at diagnosis (years), location of primary tumor (proximal, distal, rectum or unknown), grade of differentiation (well-differentiated, moderately differentiated, poorly differentiated or unknown), metastasis of the tumor (yes vs. no) and study cohort.

2

Adjusted for covariates included in Model 1 plus body mass index and physical activity before colorectal cancer diagnosis.

3

Adjusted for covariates included in Model 2 plus prediagnostic plasma C-peptide levels.

Abbreviations: BMI, body mass index; PA, physical activity; SHBG, sex hormone-binding globulin.