Ovarian volumes among women with endometrial carcinoma: Associations with risk factors and serum hormones

Objectives.: Data suggest that post-menopausal women with larger ovaries are at increased risk for endometrial carcinoma; however, analyses comparing ovarian volume to serum hormone levels are limited. Accordingly, we assessed ovarian volumes in relation to serum sex hormone levels among post-menopausal women with endometrial carcinoma who participated in a multi-center case-control study. Methods.: Data for established risk and protective factors for endometrial carcinoma were collected via in-person interviews. Ovarian volumes were estimated from pathology reports. Associations between exposures and age-adjusted ovarian volumes were analyzed for 175 cases with available data. For a subset of 135 cases, we analyzed relationships between ovarian volume, adjusted for age and body mass index (BMI), and serum hormone levels by analysis of variance. Results.: Ovarian volume declined progressively from 1.83 cm³ among women ages 55-59 years to 1.23 cm³ among women age 70 years or older (p-trend = 0.02). Larger ovarian volume was associated with early menarche (p-trend = 0.03), having given birth (p = 0.01), and weakly with elevated BMI (p-trend = 0.06). After adjustment, increased ovarian volume was associated with higher estradiol (p-trend = 0.007); albumin-bound estradiol (p-trend = 0.01); and free estradiol (p-trend = 0.006) levels; androstenedione, estrone and estrone sulfate showed similar, though non-significant associations. Conclusions.: Among women with endometrial carcinoma, larger ovaries were associated with higher serum levels of estrogens. Further studies examining the role of the ovaries in post-menopausal hormonal carcinogenesis are warranted.