Abstract

BackgroundDifferences in sex hormone levels among populations might contribute to the variation in breast cancer incidence across countries. Previous studies have shown higher breast cancer incidence and mortality among Japanese Brazilians than among Japanese. To clarify the difference in hormone levels among populations, we compared postmenopausal endogenous sex hormone levels among Japanese living in Japan, Japanese Brazilians living in the state of São Paulo, and non-Japanese Brazilians living in the state of São Paulo.MethodsA cross-sectional study was conducted using a control group of case-control studies in Nagano, Japan, and São Paulo, Brazil. Participants were postmenopausal women older than 55 years of age who provided blood samples. We measured estradiol, estrone, androstenedione, dehydroepiandrosterone sulfate (DHEAS), testosterone and free testosterone by radioimmunoassay; bioavailable estradiol by the ammonium sulfate precipitation method; and sex hormone-binding globulin (SHBG) by immunoradiometric assay. A total of 363 women were included for the present analyses, comprising 185 Japanese, 44 Japanese Brazilians and 134 non-Japanese Brazilians.ResultsJapanese Brazilians had significantly higher levels of estradiol, bioavailable estradiol, estrone, testosterone and free testosterone levels, and lower SHBG levels, than Japanese. Japanese Brazilians also had significantly higher levels of bioavailable estradiol, estrone and DHEAS and lower levels of SHBG and androstenedione than non-Japanese Brazilians. Levels of estradiol, testosterone and free testosterone, however, did not differ between Japanese Brazilians and non-Japanese Brazilians. These differences were observed even after adjustment for known breast cancer risk factors. We also found an increase in estrogen and androgen levels with increasing body mass index, but no association for most of the other known risk factors.ConclusionsWe found higher levels of estrogens and androgens in Japanese Brazilians than in Japanese and levels similar to or higher than in non-Japanese Brazilians. Our findings may help explain the increase in the incidence and mortality rate of breast cancer among Japanese Brazilians.

Highlights

  • Differences in sex hormone levels among populations might contribute to the variation in breast cancer incidence across countries

  • The mortality rate of first-generation Japanese immigrants to São Paulo, Brazil, increased from 1979 to 2001, with rates being intermediate between Japanese living in Japan and Brazilians living in the state of São Paulo [6]

  • In addition to determining lifestyle factors and genetic susceptibility to the risk of breast cancer, the protocols of these studies were designed to compare potential risk factors among Japanese living in Nagano, Japan, and Japanese Brazilians and non-Japanese Brazilians living in the state of São Paulo, Brazil

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Summary

Introduction

Differences in sex hormone levels among populations might contribute to the variation in breast cancer incidence across countries. Previous studies have shown higher breast cancer incidence and mortality among Japanese Brazilians than among Japanese. The incidence and mortality rate of breast cancer vary considerably across countries and regions [1]. The mortality rate of first-generation Japanese immigrants to São Paulo, Brazil, increased from 1979 to 2001, with rates being intermediate between Japanese living in Japan and Brazilians living in the state of São Paulo [6]. Differences in sex hormone levels among populations might contribute to the variation in breast cancer incidence across countries and regions. Clarification of the difference in sex hormone levels among populations and their determinants might help our understanding of the etiology and prevention of breast cancer

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