ONCOmmunity

Long-Term Exposure to Testosterone Therapy and the Risk of High-Grade Prostate Cancer.

By: Jacques Baillargeon, Yong-Fang Kuo, Xiao Fang, Vahakn B Shahinian

Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas; Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas; Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas. Electronic address: jbaillar@utmb.edu.
2015-5-29; doi: 10.1016/j.juro.2015.05.099

Abstract

Purpose

No population-based studies have examined whether long-term exposure to testosterone therapy is associated with an increased risk of high-grade prostate cancer. In this study, we examined whether exposure to testosterone over a 5-year period was associated with an increased risk of high-grade prostate cancer and whether this risk increased in a dose-response fashion with cumulative number of testosterone injections.

Materials

Using SEER-Medicare linked data, we identified 52,579 men who were diagnosed with incident prostate cancer between January 1, 2001 and December 31, 2006 and who had a minimum of 5 years continuous enrollment in Medicare before their cancer diagnosis. We excluded patients who were diagnosed at death or after autopsy, enrolled in a health maintenance organization in the 60 months before diagnosis, or had unknown tumor grade or tumor stage. In the 5 years before their diagnosis, 574 men had a history of testosterone use and 51,945 did not.

Results

Using logistic regression adjusting for demographic and clinical characteristics, exposure to testosterone therapy was not associated with an increased risk of high-grade prostate cancer (OR 0.84, 95% CI 0.67-1.05) or receipt of primary ADT following diagnosis (OR 0.97, 95% CI 0.74-1.30). In addition, the risk of high-grade disease did not increase according to total number of testosterone injections (OR 1.00, 95% CI 0.98-1.01).

Conclusions

Our finding that testosterone therapy was not associated with an increased risk of high-grade prostate cancer may provide important information regarding the risk-benefit assessment for men with testosterone deficiency considering treatment.