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Effect of Delays in Processing Blood Samples on Measured Endogenous Plasma Sex Hormone Levels in Women

¹ Section of Epidemiology, ² Academic Department of Biochemistry, and ³ Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, University of London; ⁴ Biochemistry Department, Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom

Requests for reprints: Michael E. Jones, Section of Epidemiology, The Institute of Cancer Research, Sir Richard Doll Building, 15 Cotswold Road, Sutton, Surrey SM2 5NG, United Kingdom. Phone: 44-20-8722-4254; Fax: 44-20-8722-4019. E-mail: michael.jones{at}icr.ac.uk

Time spent in transit may affect the concentration of various constituents of collected blood samples and, consequently, results of sex hormone assays. Whole blood was collected from 46 women, and one third was processed immediately, one third was stored at ambient conditions (22°C) for 1 day, and one third was stored for 2 days. Estradiol concentration increased by 7.1% [95% confidence interval (95% CI), 3.2-11.3%] after a delay in processing of 1 day and by 5.6% (95% CI, 0.2-11.4%) after a delay in processing of 2 days; the change was most apparent at lower than median concentrations. Progesterone concentrations showed no substantial change. Testosterone concentrations changed by 23.9% (95% CI, 17.8-30.3%) after a delay of 1 day but little thereafter. The sex hormone–binding globulin concentration decreased by 6.6% (95% CI, 4.6-8.6%) and 10.9% (95% CI, 8.1-13.6%), follicle-stimulating hormone increased by 7.4% (95% CI, 4.2-10.7%) and 13.9% (95% CI, 8.7-19.3%), and luteinizing hormone increased by 4.9% (95% CI, 1.3-8.5%) and 6.7% (95% CI, 2.2-11.5%) after a delay in processing of 1 and 2 days. Increases in calculated values for biologically available levels of estradiol and testosterone were greater than the increases seen in measured total hormone concentrations. Similar changes are likely when samples are delayed in transit, and evidence of etiology may be obscured unless study designs or analyses take into account processing delays. (Cancer Epidemiol Biomarkers Prev 2007;16(6):1136–9)

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