Testosterone Replacement Therapy and the Risk of Prostate Cancer. Is There a Link?

A. Barqawi; E. D. Crawford

Disclosures

Int J Impot Res. 2006;18(4):323-328. 

In This Article

Does Racial Background Matter?

In the United States, African-American men have the highest incidence of prostate cancer and are known to have more aggressive disease when compared with other racial groups. Although young healthy African-American men have consistently been reported to have higher levels of total and free serum testosterone,[27] a correlation between these observations and prostate cancer risk remains theoretical at best. Kubricht et al.[28] reported similar serum testosterone levels in 189 African Americans and 264 Caucasian men undergoing biopsy for prostate cancer. They concluded that men from different racial groups appear to have comparable testosterone levels beyond the age of 40 years, regardless of the presence of prostate cancer.[28] Furthermore, after adjusting for clinical stage, Mohler et al.[29] found similar tissue levels of testosterone and DHT in 36 African American and 59 Caucasian men undergoing radical prostatectomy; however, SHBG was significantly higher in the African-American men, indicating lower levels of bioavailable testosterone and the possibility of an alternative AR activation pathway. The epidemiological evidence of a higher incidence of diabetes and obesity in African-American men may also affect the overall correlation between testosterone levels and the risk of prostate cancer.

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