title: Associations of serum sex steroid hormone and 5α-androstane-3α,17β-diol glucuronide concentrations with prostate cancer risk among men treated with finasteride.
abstract: BACKGROUND
  Finasteride, an inhibitor of 5α-reductase (type II), lowers intraprostatic dihydrotestosterone (DHT), which is reflected in serum as reduced 5α-androstane-3α,17β-diol glucuronide (3α-dG). It also modestly increases serum testosterone (T), estrone (E(1)), and estradiol (E(2)). In this altered hormonal milieu, it is unknown whether serum concentrations of these hormones are associated with prostate cancer risk.
  
  
  METHODS
  In this nested case-control study of men in the finasteride arm of the Prostate Cancer Prevention Trial, sex steroid hormones and sex hormone binding globulin were measured at baseline and approximately 3-year posttreatment in 553 prostate cancer cases and 694 controls.
  
  
  RESULTS
  Median posttreatment changes in concentrations of 3α-dG, T, E(1), and E(2) were -73.8%, +10.1%, +11.2%, and +7.5% (all P < 0.001), respectively. Neither the pre- nor posttreatment concentrations of 3α-dG, nor its change, were associated with risk. Pretreatment, high concentrations of E(1) and low concentrations of T were associated with increased cancer risk [OR; 95% confidence interval (CI) quartile 4 vs. 1: 1.38 (0.99-1.93) P(trend) = 0.03; 0.64 (0.43-0.93) P(trend) = 0.07, respectively]. Posttreatment, high concentrations of both E(1) and E(2) were associated with increased cancer risk [OR; 95% CI quartile 4 vs. 1: 1.54 (1.09-2.17) P(trend) = 0.03; 1.49 (1.07-2.07) P(trend) = 0.02, respectively].
  
  
  CONCLUSIONS
  Among finasteride-treated men, concentrations of 3α-dG were not associated with total or Gleason grades 2 to 6, 7 to 10, or 8 to 10 cancer. High serum estrogens may increase cancer risk when intraprostatic DHT is pharmacologically lowered.
  
  
  CONCLUSIONS
  Low posttreatment serum estrogens may identify men more likely to benefit from use of finasteride to prevent prostate cancer.
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA. akristal@fhcrc.org
authors.forename: Alan R
authors.initials: AR
authors.lastname: Kristal
authors.forename: Cathee
authors.initials: C
authors.lastname: Till
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Tangen
authors.forename: Phyllis J
authors.initials: PJ
authors.lastname: Goodman
authors.forename: Marian L
authors.initials: ML
authors.lastname: Neuhouser
authors.forename: Frank Z
authors.initials: FZ
authors.lastname: Stanczyk
authors.forename: Lisa W
authors.initials: LW
authors.lastname: Chu
authors.forename: Sherfaraz K
authors.initials: SK
authors.lastname: Patel
authors.forename: Ian M
authors.initials: IM
authors.lastname: Thompson
authors.forename: Juergen K
authors.initials: JK
authors.lastname: Reichardt
authors.forename: Ashraful
authors.initials: A
authors.lastname: Hoque
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Platz
authors.forename: William D
authors.initials: WD
authors.lastname: Figg
authors.forename: Adrie
authors.initials: A
authors.lastname: Van Bokhoven
authors.forename: Scott M
authors.initials: SM
authors.lastname: Lippman
authors.forename: Ann W
authors.initials: AW
authors.lastname: Hsing
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use*; D000368:Aged; D015113:Androstane-3,17-diol / Q000097:blood*; D016022:Case-Control Studies; D018120:Finasteride / Q000627:therapeutic use*; D020719:Glucuronides / Q000097:blood*; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000097:blood / Q000209:etiology* / Q000517:prevention & control*; D012306:Risk; D012738:Sex Hormone-Binding Globulin / Q000032:analysis
chemical_list: D058891:5-alpha Reductase Inhibitors; D020719:Glucuronides; D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin; D015113:Androstane-3,17-diol; D018120:Finasteride