Anti-Mullerian hormone and endometrial cancer: a multi-cohort study

Renée T Fortner¹, Helena Schock¹, Seungyoun Jung², Naomi E Allen³, Alan A Arslan^{4

5}, Louise A Brinton⁶, Brian L Egleston⁷, Roni T Falk⁶, Marc J Gunter⁸, Kathy J Helzlsouer⁹, Annika Idahl¹⁰, Theron S Johnson¹, Rudolf Kaaks¹, Vittorio Krogh¹¹, Eva Lundin¹², Melissa A Merritt¹³, Carmen Navarro^{14

15

16}, N Charlotte Onland-Moret¹⁷, Domenico Palli¹⁸, Xiao-Ou Shu¹⁹, Patrick M Sluss²⁰, Paul N Staats²¹, Antonia Trichopoulou^{22

23}, Elisabete Weiderpass^{24

25

26

27}, Anne Zeleniuch-Jacquotte²⁸, Wei Zheng¹⁹, Joanne F Dorgan²

Affiliations

¹ Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany.
² Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
³ Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
⁴ Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA.
⁵ Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York University Perlmutter Cancer Center, New York, NY, USA.
⁶ Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
⁷ Fox Chase Cancer Center, Philadelphia, PA, USA.
⁸ Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
⁹ Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
¹⁰ Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.
¹¹ Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
¹² Department of Medical Biosciences and Pathology, Umeå University, Umeå, Sweden.
¹³ Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
¹⁴ Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
¹⁵ CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
¹⁶ Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain.
¹⁷ Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
¹⁸ Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy.
¹⁹ Department of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN, USA.
²⁰ Department of Pathology, Harvard Medical School, Boston, MA, USA.
²¹ Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA.
²² Hellenic Health Foundation, Athens, Greece.
²³ WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
²⁴ Department of Research, Group of Etiological Cancer Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
²⁵ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
²⁶ Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
²⁷ Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway.
²⁸ Department of Population Health and Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA.

PMID: 28873086
PMCID: PMC5672934
DOI: 10.1038/bjc.2017.299

Anti-Mullerian hormone and endometrial cancer: a multi-cohort study

Renée T Fortner et al. Br J Cancer. 2017.

. 2017 Oct 24;117(9):1412-1418.

doi: 10.1038/bjc.2017.299. Epub 2017 Sep 5.

Authors

Affiliations

¹ Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany.
² Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
³ Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
⁴ Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA.
⁵ Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York University Perlmutter Cancer Center, New York, NY, USA.
⁶ Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
⁷ Fox Chase Cancer Center, Philadelphia, PA, USA.
⁸ Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
⁹ Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
¹⁰ Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.
¹¹ Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
¹² Department of Medical Biosciences and Pathology, Umeå University, Umeå, Sweden.
¹³ Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
¹⁴ Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
¹⁵ CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
¹⁶ Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain.
¹⁷ Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
¹⁸ Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy.
¹⁹ Department of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN, USA.
²⁰ Department of Pathology, Harvard Medical School, Boston, MA, USA.
²¹ Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA.
²² Hellenic Health Foundation, Athens, Greece.
²³ WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
²⁴ Department of Research, Group of Etiological Cancer Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
²⁵ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
²⁶ Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
²⁷ Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway.
²⁸ Department of Population Health and Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA.

PMID: 28873086
PMCID: PMC5672934
DOI: 10.1038/bjc.2017.299

Abstract

Background: The Mullerian ducts are the embryological precursors of the female reproductive tract, including the uterus; anti-Mullerian hormone (AMH) has a key role in the regulation of foetal sexual differentiation. Anti-Mullerian hormone inhibits endometrial tumour growth in experimental models by stimulating apoptosis and cell cycle arrest. To date, there are no prospective epidemiologic data on circulating AMH and endometrial cancer risk.

Methods: We investigated this association among women premenopausal at blood collection in a multicohort study including participants from eight studies located in the United States, Europe, and China. We identified 329 endometrial cancer cases and 339 matched controls. Anti-Mullerian hormone concentrations in blood were quantified using an enzyme-linked immunosorbent assay. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) across tertiles and for a doubling of AMH concentrations (OR_log2). Subgroup analyses were performed by ages at blood donation and diagnosis, oral contraceptive use, and tumour characteristics.

Results: Anti-Mullerian hormone was not associated with the risk of endometrial cancer overall (OR_log2: 1.07 (0.99-1.17)), or with any of the examined subgroups.

Conclusions: Although experimental models implicate AMH in endometrial cancer growth inhibition, our findings do not support a role for circulating AMH in the aetiology of endometrial cancer.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
**ORs (95% CI) for a doubling of AMH concentrations by study cohort and overall association in pooled analysis and meta-analysis: Prospective Study of AMH and Gynecologic Cancer Risk.** ^aAdjusted for age at blood collection.

See this image and copyright information in PMC

References

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Anti-Mullerian hormone and endometrial cancer: a multi-cohort study

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Anti-Mullerian hormone and endometrial cancer: a multi-cohort study

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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