Abstract 2207: An analysis of circulating sex steroid hormones in relation to Barrett's esophagus

Abstract

Abstract Introduction: Barrett's esophagus (BE) is the precursor lesion of esophageal adenocarcinoma (EA). The male-to-female incidence rate ratio of BE is ∼2 while EA is ∼6 for reasons that remain unknown. We assessed whether sex steroid hormones were associated with BE in a male population. Methods: The Barrett's Esophagus Early Detection Case Control Study (BEEDS) was based at the National Naval Medical Center (NMMC). We quantitated 13 sex steroid hormones, using mass spectrometry, and sex hormone binding globulin (SHBG), using ELISA, in 173 male BE patients and 213 endoscopy-negative controls. We also calculated free estradiol and free testosterone using formulas known to accurately estimate such. We used multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for smoking status, alcohol consumption, body mass index (BMI; kg/m2), heartburn, regurgitation, and gastroesophageal symptom score (excluding heartburn and regurgitation). Results: Free testosterone was positively associated with BE risk, peaking in the highest quartile with an OR of 4.42 (95%CI: 1.91, 10.24, p=0.0005). Estrone-sulphate was inversely associated with BE risk (OR 4th quartile=0.23, 95%CI:0.10, 0.53, p=0.0006). No other hormone was associated with BE risk. Relationships were not modified by age or BMI. Conclusion: High testosterone may delay re-epithelization of esophageal lesions leading to increased risk of metaplastic growth. Citation Format: Michael B. Cook, Shannon Wood, Brooks D. Cash, Patrick Young, Ruben D. Acosta, Roni T. Falk, Ruth Pfeiffer, Nan Hu, Carol Giffen, Veronique Turcotte, Patrick Caron, Chantal Guillemette, Sanford M. Dawsey, Christian C. Abnet, Paula L. Hyland, Philip R. Taylor. An analysis of circulating sex steroid hormones in relation to Barrett's esophagus. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2207. doi:10.1158/1538-7445.AM2014-2207