Evidence map›Paper›PMID 27193440›Full record

ArticleJournal of the National Cancer Institute2016

Endogenous Estrogens, Estrogen Metabolites, and Breast Cancer Risk in Postmenopausal Chinese Women.

Steven C Moore, Charles E Matthews, Xiao Ou Shu, Kai Yu, Mitchell H Gail, Xia Xu, Bu-Tian Ji, Wong-Ho Chow, Qiuyin Cai, Honglan Li and 8 more

Open access · bronzeAbstract read
In one paragraph

Article in Journal of the National Cancer Institute, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 2 pooled it
3.2field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 100 citations in OpenAlex.

  1. Pooled it
  2. Linking Physical Activity to Breast Cancer via Sex Steroid Hormones, Part 2: The Effect of Sex Steroid Hormones on Breast Cancer Risk.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022
    Pooled it
  3. Article
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  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
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  13. Article
  14. Sulfite may disrupt estrogen homeostasis in human via inhibition of steroid arylsulfatase.Environmental science and pollution research international · 2022
    Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Review
  20. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 8 institutions in 2 countries.

Steven C MooreAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Charles E MatthewsAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Xiao Ou ShuAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Kai YuAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Mitchell H GailAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Xia XuAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Bu-Tian JiAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Wong-Ho ChowAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Qiuyin CaiAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Honglan LiAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Gong YangAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
David RuggieriAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Jennifer Boyd-MorinAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Nathaniel RothmanAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Robert N HooverAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Yu-Tang GaoAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Wei ZhengAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Regina G ZieglerAffiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SCM, CEM, KY, MHG, BTJ, NR, RNH, RGZ); Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN (XOS, QC, GY, WZ); Frederick National Laboratory for Cancer Research, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick, MD (XX); Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (HL, YTG); Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX (WHC); Information Management Services, Inc., Rockville, MD (DR, JBM).
Division of Cancer Epidemiology and GeneticsLeidos (United States) · USFrederick National Laboratory for Cancer Research · USLeidos Biomedical Research Inc. (United States)The University of Texas MD Anderson Cancer Center · USInformation Management Services · USNational Cancer Institute · USVanderbilt University · US

Funding

Nutrition, Metabolism, and CancerZIACP010169 · NCI · DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS · PI GIERACH, GRETCHEN · 2009 to 2025
$9.2M
Shanghai Womens Health StudyUM1CA182910 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ZHENG, WEI · 2014 to 2018
$5.9M
Cancer Risk Reduction and Diet: A Cohort Study of WomenR37CA070867 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ZHENG, WEI · 2009 to 2013
$4.7M
NCI NIH HHS R37 CA070867NCI NIH HHS UM1 CA182910
6 · The paper itself

Abstract

backgroundThe role of estrogen metabolism in determining breast cancer risk and differences in breast cancer rates between high-incidence and low-incidence nations is poorly understood.

methodsWe measured urinary concentrations of estradiol and estrone (parent estrogens) and 13 estrogen metabolites formed by irreversible hydroxylation at the C-2, C-4, or C-16 positions of the steroid ring in a nested case-control study of 399 postmenopausal invasive breast cancer case participants and 399 matched control participants from the population-based Shanghai Women's Health Study cohort. Odds ratios (ORs) and 95% confidence intervals (CIs) of breast cancer by quartiles of metabolic pathway groups, pathway ratios, and individual estrogens/estrogen metabolites were estimated by multivariable conditional logistic regression. Urinary estrogen/estrogen metabolite measures were compared with those of postmenopausal non-hormone-using Asian Americans, a population with three-fold higher breast cancer incidence rates. All statistical tests were two-sided.

resultsUrinary concentrations of parent estrogens were strongly associated with breast cancer risk (ORQ4vsQ1 = 1.94, 95% CI = 1.21 to 3.12, Ptrend = .01). Of the pathway ratios, the 2-pathway:total estrogens/estrogen metabolites and 2-pathway:parent estrogens were inversely associated with risk (ORQ4vsQ1 = 0.57, 95% CI = 0.35 to 0.91, Ptrend = .03, and ORQ4vsQ1 = 0.61, 95% CI = 0.37 to 0.99, Ptrend = .04, respectively). After adjusting for parent estrogens, these associations remained clearly inverse but lost statistical significance (ORQ4vsQ1 = 0.65, 95% CI = 0.39 to 1.06, Ptrend = .12 and ORQ4vsQ1 = 0.76, 95% CI = 0.44 to 1.32, Ptrend = .28). The urinary concentration of all estrogens/estrogen metabolites combined in Asian American women was triple that in Shanghai women.

conclusionsLower urinary parent estrogen concentrations and more extensive 2-hydroxylation were each associated with reduced postmenopausal breast cancer risk in a low-risk nation. Markedly higher total estrogen/estrogen metabolite concentrations in postmenopausal United States women (Asian Americans) than in Shanghai women may partly explain higher breast cancer rates in the United States.

Indexed as

AgedAsianBreast NeoplasmsCase-Control StudiesChinaEstradiolEstrogensEstroneFemaleHumansIncidenceMetabolic Networks and PathwaysMiddle AgedOdds RatioPostmenopauseUnited StatesEstradiolEstrogensEstrone

Identifiers

PMID27193440
PMCPMC5858156
OpenAlexW2404217920

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.