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This test measures the ratio of 2-hydroxy (E1-Estrone + E2-Estradiol) to 16 alpha- hydroxyestrone in a random urine sample. Evidence indicates that this ratio is relevant as a risk factor for estrogen-sensitive diseases including breast and cervical cancers as well as some autoimmune diseases.

The ratio of 2-hydroxyestrone to 16 alpha-hydroxyestrone is not only a risk factor of breast cancer but also other conditions of inappropriate estrogen activity.
16 alpha-hydroxyestrone stimulates prolif­eration (cell growth), sometimes contraindicated in certain diseases, where 2 hydroxyestrogens have been shown to be protective against or lessen risk of cancer. Because there is an optimal level of both 2- and 16-hydroxyestrone, a ratio comparing the two levels can be very helpful. A 2:16 ratio is highly correlated with breast cancer. In 10,786 women, followed for 5.5 years, higher 2:16 ratios correlated with lower risk of breast cancer.

Cancers that react favorably to a higher 2:16 ratio

• ER + breast cancer
• ER – breast cancer
• Prostate cancer
• Cervical cancer
• Ovarian cancer
• Laryngeal cancer

16 alpha-hydroxyestrone has been found to be elevated in those at risk for breast cancer, as well as other conditions associated with hyperimmune activity such as sys­temic lupus erythematosis and rheumatoid arthritis. In these populations 16 alpha-hydroxyestrone was 10 times higher than the control population
Testing for the urinary levels of 2-hydroxyestrone and 16 alpha–hydroxyestrone provides valuable insight re­garding disease risk. Improvements of the ratio can be made through dietary recommendations and supplements that specifically improve the 2OH pathway.