Is a Decreased Serum Testosterone Level a Risk Factor for Prostate Cancer? A Cohort Study of Korean Men.
10.4111/kju.2010.51.12.819
- Author:
Bo Sung SHIN
1
;
Eu Chang HWANG
;
Chang Min IM
;
Sun ouck KIM
;
Seung Il JUNG
;
Taek Won KANG
;
Dong Deuk KWON
;
Kwangsung PARK
;
Soo Bang RYU
Author Information
1. Department of Urology, Chonnam National University Medical School, Gwangju, Korea. urokwon@gmail.com
- Publication Type:Original Article
- Keywords:
Prostatic neoplasms;
Risk factors;
Testosterone
- MeSH:
Biopsy;
Cohort Studies;
Humans;
Incidence;
Male;
Prostate;
Prostate-Specific Antigen;
Prostatic Neoplasms;
Risk Factors;
Testosterone
- From:Korean Journal of Urology
2010;51(12):819-823
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To investigate patients who had transrectal ultrasonography (TRUS)-guided prostate biopsy to define the role of the serum testosterone level in predicting prostate cancer risk and its association with a high Gleason score. MATERIALS AND METHODS: A total of 568 patients who underwent prostate biopsy were entered in this study. We divided the patients into two groups according to serum testosterone level (median level, 3.85 ng/ml): the high-testosterone group (n=285) and the low-testosterone group (n=283). Multivariate regression analysis was used to define the effect of age, prostate volume, serum prostate-specific antigen (PSA) level and PSA density, and serum testosterone level on the risk of prostate cancer and a high Gleason score. RESULTS: Baseline characteristics did not differ significantly between the two groups. Compared with the high-testosterone group, the low-testosterone group had a significantly higher prostate cancer incidence (38.9% vs. 29.5%, p=0.018). Factors associated with an increased risk of prostate cancer were increased age (odds ratio [OR]=1.08, 95% confidence interval [CI]=1.25-3.16, p=0.001), a high serum PSA level (OR=3.35, 95% CI=2.63-4.25, p=0.001), a low prostate volume (OR=0.183, 95% CI=0.11-0.30, p=0.001), and a low serum testosterone level (OR=1.99, 95% CI=1.25-3.16, p=0.001). Among these, only the serum PSA level was a strong predictor of high-grade prostate cancer (Gleason score > or =7) (OR=2.19, 95% CI=1.57-2.95, p=0.001). CONCLUSIONS: Patients with lower levels of serum testosterone had a higher risk of prostate cancer than did patients with high serum testosterone. Even though a lower serum testosterone level was a predictor of prostate cancer risk, it was not associated with an increased risk of high-grade prostate cancer.
