Table 3.

OR and 95% CIs for the risk of epithelial ovarian cancer subtypes comparing the 5th quintile to the 1st quintile for individual estrogens and estrogen metabolites, nested case–control study within the WHI-OS

SerousNonserous
n = 102n = 67FDR
ORa (95% CI)PtrendbORa (95% CI)PtrendbPhetcTrenddHetd
Parent estrogens
 Estrone1.11 (0.52–2.33)0.562.65 (1.09–6.45)0.010.040.020.05
  Unconjugated estrone1.14 (0.52–2.50)0.671.95 (0.86–4.41)0.010.010.020.04
  Conjugated estrone1.03 (0.48–2.21)0.713.15 (1.24–8.01)0.010.030.020.05
 Estradiol0.60 (0.29–1.23)0.421.79 (0.71–4.51)0.220.090.230.09
  Unconjugated estradiol0.97 (0.44–2.16)0.582.72 (1.04–7.14)0.030.020.040.04
  Conjugated estradiol0.81 (0.38–1.72)0.411.63 (0.67–3.96)0.270.160.270.16
2-Hydroxylation pathway
 2-Hydroxyestrone0.76 (0.35–1.65)0.724.27 (1.52–12.01)0.010.010.020.04
 2-Hydroxyestradiol0.71 (0.33–1.55)0.421.70 (0.68–4.26)0.110.020.130.04
 2-Methoxyestrone1.27 (0.59–2.73)0.584.26 (1.68–10.81)0.0010.010.010.04
  Unconjugated 2-methoxyestrone0.87 (0.39–1.96)0.853.20 (1.15–8.92)0.020.010.030.04
  Conjugated 2-methoxyestrone0.98 (0.45–2.14)0.863.66 (1.46–9.19)0.0030.020.020.04
 2-Methoxyestradiol1.11 (0.51–2.39)0.992.36 (0.94–5.94)0.030.050.040.06
  Unconjugated 2-methoxyestradiol1.23 (0.56–2.70)0.942.96 (1.18–7.44)0.020.040.030.05
  Conjugated 2-methoxyestradiol0.89 (0.41–1.90)0.742.32 (0.93–5.79)0.030.050.040.06
 2-Hydroxyestrone-3-methyl ether0.76 (0.36–1.64)0.802.36 (0.84–6.65)0.130.080.140.09
4-Hydroxylation pathway
 4-Hydroxyestrone1.00 (0.46–2.16)0.803.13 (1.21–8.06)0.010.020.020.04
 4-Methoxyestrone1.21 (0.57–2.58)0.323.25 (1.31–8.10)0.0010.030.010.05
 4-Methoxyestradiol1.20 (0.55–2.65)0.992.91 (1.11–7.64)0.010.020.020.04
16α-Hydroxylation pathway
 16α-Hydroxyestrone0.76 (0.35–1.65)0.763.56 (1.32–9.64)0.020.010.030.04
 Estriol1.10 (0.51–2.36)0.603.76 (1.41–10.01)0.010.020.020.04
  Unconjugated estriol0.85 (0.37–1.93)0.472.37 (0.96–5.85)0.010.0010.020.03
  Conjugated estriol0.99 (0.46–2.14)0.802.55 (1.02–6.40)0.020.040.030.05
 16-Ketoestradiol0.91 (0.42–1.95)0.962.98 (1.16–7.63)0.010.020.020.04
 16-Epiestriol0.65 (0.29–1.48)0.253.46 (1.18–10.15)0.050.010.060.04
 17-Epiestriol0.96 (0.44–2.09)0.742.85 (0.97–8.34)0.120.050.140.06
  • aOR from model adjusting for matching factors (age at baseline, year of blood draw, race/ethnicity, hysterectomy status), recency of menopausal hormone therapy use (never, ≤1, >1), body mass index, smoking status, gravidity, and duration of oral contraceptive use.

  • bP values for trend across quintile (median value of category).

  • cPheterogeneity.

  • dFDR q-value corresponding to the Ptrend among nonserous tumors and the test for heterogeneity across subtype.