SERUM GONADOTROPINS AND STEROID-HORMONES AND THE DEVELOPMENT OF OVARIAN-CANCER

Objective.-To prospectively examine the association between endogenous hormones and development of ovarian cancer. Design.-Nested case-contr ol study. Setting.-A population-based serum bank in Washington County, Maryland. Participants.-Serum samples were collected in 1974 from 20 305 county residents and stored at - 70 degrees C. From 1975 through 1 989, a total of 31 cases of ovarian cancer were identified in women wh o were not taking hormones at the time of blood collection. These case s were matched to 62 controls on age, menopausal status, and, for prem enopausal women, number of days from the beginning of the last menstru al period. Main Outcome Measure.-Prediagnostic endogenous hormone leve ls of cases and controls were compared. Results.-Mean follicle-stimula ting hormone levels were lower among cases (43.3 IU/L) compared with c ontrols (54.4 IU/L) (P=.04), and increasing levels were associated wit h significantly lower risk (P for trend=.01), particularly among postm enopausal women. Luteinizing hormone levels were 9% lower among cases than controls, but the difference was not statistically significant (P =.39). Compared with controls, cases had higher androstenedione levels (4.5 nmol/L vs 3.3 nmol; P=.03) and higher dehydroepiandrosterone (DH EA) levels (15.9 nmol/L vs 9.7 nmol/L; P=.02). The risk of ovarian can cer increased with higher levels of androstenedione and DHEA sulfate ( P for trend=.008 and .11, respectively). These associations were not m aterially different between premenopausal and postmenopausal women. Co nclusion.-The results suggest that women with low serum gonadotropin l evels or high androgen levels have an increased risk of ovarian cancer . These findings do not support the hypothesis that pituitary gonadotr opins increase the risk of ovarian cancer. Replication of the study in other populations is highly desirable.