{"doi":"10.17615/mv6n-nj16","title":"Urinary estrogen metabolites and long-term mortality following breast cancer","abstract":"Background: Estrogen metabolite concentrations of 2-hydroxyestrone (2-OHE1) and 16-hydroxyestrone (16-OHE1) may be associated with breast carcinogenesis. However, no study has investigated their possible impact on mortality after breast cancer. Methods: This population-based study was initiated in 1996–1997 with spot urine samples obtained shortly after diagnosis (mean ¼ 96 days) from 683 women newly diagnosed with first primary breast cancer and 434 age-matched women without breast cancer. We measured urinary concentrations of 2-OHE1 and 16-OHE1 using an enzyme-linked immunoassay. Vital status was determined via the National Death Index (n ¼ 244 deaths after a median of 17.7 years of follow-up). We used multivariable-adjusted Cox proportional hazards to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the estrogen metabolites-mortality association. We evaluated effect modification using likelihood ratio tests. All statistical tests were two-sided. Results: Urinary concentrations of the 2-OHE1 to 16-OHE1 ratio (>median of 1.8 vs <median) were inversely associated with all-cause mortality (HR ¼ 0.74, 95% CI ¼ 0.56 to 0.98) among women with breast cancer. Reduced hazard was also observed for breast cancer mortality (HR ¼ 0.73, 95% CI ¼ 0.45 to 1.17) and cardiovascular diseases mortality (HR ¼ 0.76, 95% CI ¼ 0.47 to 1.23), although the 95% confidence intervals included the null. Similar findings were also observed for women without breast cancer. The association with all-cause mortality was more pronounced among breast cancer participants who began chemotherapy before urine collection (n ¼ 118, HR ¼ 0.42, 95% CI ¼ 0.22 to 0.81) than among those who had not (n ¼ 559, HR ¼ 0.98, 95% CI ¼ 0.72 to 1.34; Pinteraction ¼ .008). Conclusions: The urinary 2-OHE1 to 16-OHE1 ratio may be inversely associated with long-term all-cause mortality, which may depend on cancer treatment status at the time of urine collection.","journal":"UNC Libraries","year":2024,"id":499386,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9121,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":456588,"name":"Alfred I. Neugut","orcid":"0000-0002-5949-4522","position":1,"is_corresponding":false},{"id":1347891,"name":"Jr. Parada","orcid":null,"position":2,"is_corresponding":false},{"id":10639,"name":"T. Wang","orcid":"0000-0002-1152-2221","position":3,"is_corresponding":false},{"id":251556,"name":"Mary Beth Terry","orcid":"0000-0002-4106-5033","position":4,"is_corresponding":false},{"id":1347892,"name":"M.D Gammon","orcid":null,"position":5,"is_corresponding":false},{"id":453016,"name":"Sarah J. Nyante","orcid":"0000-0002-1770-5993","position":6,"is_corresponding":false},{"id":369709,"name":"Nikhil K. Khankari","orcid":"0000-0002-8802-4431","position":7,"is_corresponding":false},{"id":980427,"name":"P.T. Bradshaw","orcid":null,"position":8,"is_corresponding":false},{"id":230332,"name":"Steven L. Teitelbaum","orcid":"0000-0002-4054-6679","position":9,"is_corresponding":false},{"id":161429,"name":"Regina M. Santella","orcid":null,"position":10,"is_corresponding":false},{"id":275144,"name":"Hazel B. Nichols","orcid":"0000-0003-0972-1560","position":11,"is_corresponding":false},{"id":71794,"name":"Patricia G. Moorman","orcid":"0000-0002-2978-6495","position":12,"is_corresponding":false},{"id":1347890,"name":"G C Kabat","orcid":null,"position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:09:53.188165Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}