Current opinion on the role of testosterone in the development of prostate cancer: a dynamic model.
BACKGROUND
Since the landmark study conducted by Huggins and Hodges in 1941, a failure to distinguish between the role of testosterone in prostate cancer development and progression has led to the prevailing opinion that high levels of testosterone increase the risk of prostate cancer. To date, this claim remains unproven.


OBJECTIVE
We present a novel dynamic mode of the relationship between testosterone and prostate cancer by hypothesizing that the magnitude of age-related declines in testosterone, rather than a static level of testosterone measured at a single point, may trigger and promote the development of prostate cancer.


METHODS
Although not easily testable currently, prospective cohort studies with population-representative samples and repeated measurements of testosterone or retrospective cohorts with stored blood samples from different ages are warranted in future to test the hypothesis.


CONCLUSIONS
Our dynamic model can satisfactorily explain the observed age patterns of prostate cancer incidence, the apparent conflicts in epidemiological findings on testosterone and risk of prostate cancer, racial disparities in prostate cancer incidence, risk factors associated with prostate cancer, and the role of testosterone in prostate cancer progression. Our dynamic model may also have implications for testosterone replacement therapy.
Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M Health Science Center, 205A SRPH Administration Building | MS 1266, 212 Adriance Lab Road, College Station, TX, 77843-1266, USA. xiaohui.xu@sph.tamhsc.edu.
Xiaohui
X
Xu
Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA. jimax.chen@phhp.ufl.edu.
Xinguang
X
Chen
Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA. huihu@ufl.edu.
Hui
H
Hu
Health Sciences Department, Gettysburg College, Gettysburg, PA, USA. adailey@gettysburg.edu.
Amy B
AB
Dailey
Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M Health Science Center, 205A SRPH Administration Building | MS 1266, 212 Adriance Lab Road, College Station, TX, 77843-1266, USA. taylor@sph.tamhsc.edu.
Brandie D
BD
Taylor
D000818:Animals; D018450:Disease Progression; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D012189:Retrospective Studies; D012307:Risk Factors; D013739:Testosterone / Q000502:physiology*
D013739:Testosterone