Relationship between Endogenous Sex Hormones and Prostate Cancer Not Demonstrated in Prospective Study: Previous epidemiologic studies relating serum hormone levels to prostate cancer (CaP) risk have been inconclusive. In the International Journal of Cancer, Dr. Weiss and associates report a large nested case-control study including 727 cases and 889 controls using pre-diagnostic serum samples in the prospective Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. They examined associations between androstenedione (4-A), testosterone (T), sex hormone-binding globulin (SHBG), and 3 androstanedio glucuronide (3-diolG) with the risk of CaP. This study had the benefit of a large size that would permit evaluation of androgen-associated risks in relation to CaP aggressiveness and to consider risks in population subgroups.
The PLCO screening trial is a two-armed, randomized controlled trial designed to evaluate the effectiveness of prostate, lung, colorectal, and ovarian cancer screening and to investigate etiologic factors and early markers of cancer. Case diagnosis followed an elevated PSA (57%), an abnormal rectal exam (14%), and both (17%). Most serum hormone levels were not correlated with PSA in cases or controls, however T:SHBG was correlated with PSA in controls. Although risks tended to increase with greater total, free, and bioavailable T, and to decrease with greater SHBG, these findings were not statistically significant. T:SHBG ratio, however, was associated with increased risk for CaP especially in men age 65 years and older.
In summary, there is not significant convincing evidence of a relationship between serum sex hormones and prostate cancer.
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