MP4-09 ENDOGENOUS AND EXOGENOUS TESTOSTERONE AND THE RISK OF PROSTATE CANCER AND PROSTATE SPECIFIC ANTIGEN (2015)

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History I1 Apr 2015MP4-09 ENDOGENOUS AND EXOGENOUS TESTOSTERONE AND THE RISK OF PROSTATE CANCER AND PROSTATE SPECIFIC ANTIGEN Peter Boyle, Alice Koechlin, Maria Bota, Alberto d'Onofrio, David G. Zaridze, Paul Perrin, John Fitzpatrick, Arthur L. Burnett, and Mathieu Boniol Peter BoylePeter Boyle More articles by this author , Alice KoechlinAlice Koechlin More articles by this author , Maria BotaMaria Bota More articles by this author , Alberto d'OnofrioAlberto d'Onofrio More articles by this author , David G. ZaridzeDavid G. Zaridze More articles by this author , Paul PerrinPaul Perrin More articles by this author , John FitzpatrickJohn Fitzpatrick More articles by this author , Arthur L. BurnettArthur L. Burnett More articles by this author , and Mathieu BoniolMathieu Boniol More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.152AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To review and quantify the association between endogenous and exogenous testosterone and prostate specific antigen (PSA) and prostate cancer. METHODS Literature searches were performed following the PRISMA guidelines. Prospective cohort studies that reported data on the associations between endogenous testosterone and prostate cancer, and placebo controlled randomised trial studies of testosterone replacement therapy that reported data on PSA and prostate cancer cases were retained. Meta-analyses were carried out using a random effects model with tests for statistical significance, publication bias and heterogeneity. RESULTS Twenty estimates derived from 18 studies, based on a total of 5,091 patients with prostate cancer and 11,930 controls, were included in a meta-analysis which produced a summary relative risk (SRR) of prostate cancer for the highest vs. lowest quantile of serum testosterone of SRR=0.98 (95% CI (0.88, 1.09)). Based on data from 24 trials, the overall difference in PSA levels following onset of use of testosterone replacement therapy was 0.11 ng/mL (95% CI (-0.23, 0.46)) which was not statistically significant. When restricting to transdermal testosterone replacement therapy, the overall difference in PSA levels was 0.23 ng/mL (95% CI (-0.53, 0.99)) which, again, is not statistically significant. The summary relative risk of prostate cancer as an adverse effect from 11 TRT trials was SRR=0.94 (95% CI (0.37; 2.40)), again not statistically significant. CONCLUSIONS Prostate cancer development appears to be unrelated to endogenous serum testosterone levels. Testosterone replacement therapy for symptomatic hypogonadism does not appear to increase PSA levels nor the risk of prostate cancer development. The current data are reassuring although care is essential until multiple studies with longer follow-up are available. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e30 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peter Boyle More articles by this author Alice Koechlin More articles by this author Maria Bota More articles by this author Alberto d'Onofrio More articles by this author David G. Zaridze More articles by this author Paul Perrin More articles by this author John Fitzpatrick More articles by this author Arthur L. Burnett More articles by this author Mathieu Boniol More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...