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Energy balance and cancer: the role of sex hormones

Published online by Cambridge University Press:  28 February 2007

Timothy J. Key ,
Naomi E. Allen ,
Pia K. Verkasalo  and
Emily Banks
Timothy J. Key*
Affiliation:
Imperial Cancer Research Fund, Cancer Epidemiology Unit, University of Oxford, Oxford OX2 6HE, UK
Naomi E. Allen
Affiliation:
Imperial Cancer Research Fund, Cancer Epidemiology Unit, University of Oxford, Oxford OX2 6HE, UK
Pia K. Verkasalo
Affiliation:
Imperial Cancer Research Fund, Cancer Epidemiology Unit, University of Oxford, Oxford OX2 6HE, UK
Emily Banks
Affiliation:
Imperial Cancer Research Fund, Cancer Epidemiology Unit, University of Oxford, Oxford OX2 6HE, UK
*
*Corresponding author: Dr Timothy J. Key, fax +44 1865 310 545, email key@icrf.icnet.uk
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Abstract

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Energy balance can affect the risk for hormone-related cancers by altering sex hormone levels. Energy intake and expenditure are difficult to measure in epidemiological studies, but a chronic excess of intake relative to expenditure leads to a high BMI, which can be accurately measured. In premenopausal women obesity has little effect on the serum concentration of oestradiol, but causes an increase in the frequency of anovular menstrual cycles and thus a reduction in progesterone levels; these changes lead to a large increase in the risk for endometrial cancer, but little change, or a small decrease, in the risk for breast cancer. In post-menopausal women oestradiol levels are not regulated by negative feedback, and obesity causes an increase in the serum concentration of bioavailable oestradiol; this factor causes increases in the risk for both endometrial cancer and breast cancer. The development of ovarian cancer appears to be related more strongly to the frequency of ovulation than to direct effects of circulating levels of sex hormones, and BMI is not clearly associated with the risk for ovarian cancer. In men, increasing BMI has little effect on bioavailable androgen levels, and any effect of obesity on prostate cancer risk is small.

Keywords

Energy balanceObesityCancerSex hormones
Type
Macronutrient Metabolism Group Symposium on ‘Energy flux and cancer’
Information
Proceedings of the Nutrition Society , Volume 60 , Issue 1 , February 2001 , pp. 81 - 89
Copyright
Copyright © The Nutrition Society 2001

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