© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 7, 650,
April 7, 1999
© 1999 Oxford University Press
CORRESPONDENCE |
Re: Hormonal Etiology of Epithelial Ovarian Cancer, With a Hypothesis Concerning the Role of Androgens and Progesterone
Correspondence to: Thomas C. Hamilton, Ph.D., Ovarian Cancer Research Program, Fox Chase Cancer Center, 7701 Burholme Ave., Philadelphia, PA 19111.
I read with interest the review article by Risch (1). Dr. Risch is to be complemented on calling this topic to the attention of the scientific community. I find the most striking feature of the article to be the limited experimental progress made in this area since the development of the incessant ovulation hypothesis by Fathalla (2) in 1971 and the discovery of steroid hormone receptors in normal ovarian surface epithelial cells and ovarian tumors in the late 1970s to early 1980s (3,4) and speculation on their roles in ovarian cancer etiology (5).
I would like to make a few specific points about the concepts presented. First, it is certainly most likely that additional factors from incessant ovulation contribute to ovarian cancer risk. It, however, seems somewhat simplistic to rule out a major role for this process on the basis of the relationship between ovulatory inhibition as a proportion of lifetime ovulatory cycles without considering that the effect may follow a relationship that is nonlinear, as is typical of many biologic processes. Secondly, the author builds a circumstantial case for the role of gonadotropins in ovarian cancer etiology. This may well be the case, but his literature citations in experimental support of this hypothesis by and large relate to the induction of granulosa and stromal tumors, which is not the topic of this review.
In conclusion, epidemiologic studies continue to slowly add data suggesting a role for hormones, both steroid and peptide, in ovarian cancer etiology, but experimental progress is painfully slow. This slow progress must be due in large part to the small size of the ovarian cancer research community, as was recently highlighted at a joint meeting of the National Cancer Institute and the Society for Gynecologic Oncologists held in Bethesda, MD on December 14 and 15, 1998.
REFERENCES
1
Risch HA. Hormonal etiology of epithelial ovarian cancer, with a
hypothesis concerning the role of androgens and progesterone. J Natl Cancer Inst 1998;90:1774-86.
2 Fathalla MF. Incessant ovulation—a factor in ovarian neoplasia? Lancet 1971;2:163.[CrossRef][Web of Science][Medline]
3
Hamilton TC, Davies P, Griffiths K. Androgen and oestrogen
binding in cytosols of human ovarian tumors. J Endocrinol 1981;90:421-31.
4
Hamilton TC, Davies P, Griffiths K. Oestrogen receptor-like
binding in the surface germinal epithelium of the rat ovary. J Endocrinol 1982;95:377-85.
5 Hamilton TC, Davies P. Hormonal relationships in ovarian cancer. Reviews on Endocrine-Related Cancer 1983;14:19-22.
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