Armstrong B
IARC Sci Publ. 1982(39):193-221.
Endogenous hormones probably do not initiate cancer directly but may influence carcinogenesis by facilitation or inhibition of endogenous production of carcinogens; effects on the metabolic activation or inactivation of carcinogens; alteration of the susceptibility of tissues to the initiation of cancer; promotion of the development of clinical cancer from initiated cells; and (theoretically) alteration of the body's capacity to eliminate initiated cells. Evidence exists for a role of endogenous hormones in cancers of the salivary gland, colon and rectum, liver, gall-bladder, pancreas, breast, cervix uteri, corpus uteri, ovary, prostate, testis, kidney, thyroid and pituitary glands and malignant melanoma. Oestrogens are the most commonly implicated hormone, and there is sufficient evidence for their causal association with cancers of the breast and endometrium. The most commonly postulated mechanisms of action are alteration of the susceptibility of tissues to initiation, and promotion of the once-initiated cancer. In human beings and, to some extent, in animals it is difficult to distinguish between these two mechanisms, both of which are based on hormone-induced cell proliferation, because the time of initiation cannot be pinpointed. Environmental factors may influence carcinogenesis by effects on the production, transport, peripheral action, inactivation and excretion of endogenous hormones. Examples that illustrate some of these possibilities may be derived from the effects of diet on risk of breast, endometrial and thyroid cancers.
内源性激素可能不会直接引发癌症，但可能通过促进或抑制内源性致癌物的产生、影响致癌物的代谢活化或失活、改变组织对癌症起始的易感性、促进起始细胞发展为临床癌症以及（理论上）改变机体清除起始细胞的能力来影响致癌作用。有证据表明内源性激素在唾液腺、结肠和直肠癌、肝脏、胆囊、胰腺、乳腺、子宫颈、子宫体、卵巢、前列腺、睾丸、肾脏、甲状腺和垂体的癌症以及恶性黑色素瘤中发挥作用。雌激素是最常涉及的激素，有充分证据表明它们与乳腺癌和子宫内膜癌存在因果关联。最常假定的作用机制是改变组织对起始的易感性以及促进一旦起始的癌症发展。在人类以及在一定程度上在动物中，很难区分这两种机制，因为它们都基于激素诱导的细胞增殖，而且起始时间无法精确确定。环境因素可能通过对内源性激素的产生、运输、外周作用、失活和排泄产生影响来影响致癌作用。说明其中一些可能性的例子可以从饮食对乳腺癌、子宫内膜癌和甲状腺癌风险的影响中得出。
