High levels of circulating testosterone are not associated with increased prostate cancer risk: a pooled prospective study.
Androgens stimulate prostate cancer in vitro and in vivo. However, evidence from epidemiologic studies of an association between circulating levels of androgens and prostate cancer risk has been inconsistent. We investigated the association of serum levels of testosterone, the principal androgen in circulation, and sex hormone-binding globulin (SHBG) with risk in a case-control study nested in cohorts in Finland, Norway and Sweden of 708 men who were diagnosed with prostate cancer after blood collection and among 2,242 men who were not. In conditional logistic regression analyses, modest but significant decreases in risk were seen for increasing levels of total testosterone down to odds ratio for top vs. bottom quintile of 0.80 (95% CI = 0.59-1.06; p(trend) = 0.05); for SHBG, the corresponding odds ratio was 0.76 (95% CI = 0.57-1.01; p(trend) = 0.07). For free testosterone, calculated from total testosterone and SHBG, a bell-shaped risk pattern was seen with a decrease in odds ratio for top vs. bottom quintile of 0.82 (95% CI = 0.60-1.14; p(trend) = 0.44). No support was found for the hypothesis that high levels of circulating androgens within a physiologic range stimulate development and growth of prostate cancer.
Stattin
Pär
P
Department of Urology, Umeå University Hospital, Umeå, Sweden. par.stattin@urologi.umu.se
Lumme
Sonja
S
Tenkanen
Leena
L
Alfthan
Henrik
H
Jellum
Egil
E
Hallmans
Göran
G
Thoresen
Steinar
S
Hakulinen
Timo
T
Luostarinen
Tapio
T
Lehtinen
Matti
M
Dillner
Joakim
J
Stenman
Ulf-Håkan
UH
Hakama
Matti
M
D000328:Adult; D000368:Aged; D000728:Androgens / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011446:Prospective Studies; D011467:Prostate; D011471:Prostatic Neoplasms / Q000097:blood* / Q000453:epidemiology*; D012307:Risk Factors; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013548:Sweden / Q000453:epidemiology; D013739:Testosterone / Q000097:blood*
D000728:Androgens; D015415:Biomarkers; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone