Higher Dihydrotestosterone Is Associated with the Incidence of Lung Cancer in Older Men
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Advancing age is associated with increased cancer incidence, but the role of sex hormones as risk predictors for common cancers in older men remains uncertain. This study was performed to assess associations of testosterone (T), dihydrotestosterone (DHT) and estradiol (E2), with incident prostate, lung and colorectal cancer in community-dwelling older men. Plasma T, DHT and E2 were assayed using liquid chromatography-mass spectrometry between 2001 and 2004 in 3690 men. Cancer outcomes until 20 June 2013 were ascertained using data linkage. Analyses were performed using proportional hazards competing-risks models, and adjustments were made for potential confounding factors including smoking status. Results are expressed as subhazard ratios (SHR). There were 348, 107 and 137 cases of prostate, lung and colorectal cancers respectively during a median of 9.1-year follow-up. Mean T was comparable in current and non-smokers, whilst mean DHT was lower in ex- and current smokers compared to non-smokers. After adjusting for confounders including smoking, higher T or DHT was associated with an increased incidence of lung cancer (SHR = 1.30, 95% CI 1.06–1.60; p = 0.012 per 1 SD increase in T and SHR = 1.29, 95% CI 1.08–1.54; p = 0.004 for DHT). Sex hormones were not associated with prostate or colorectal cancer. In older men, higher T or DHT predict increased incidence of lung cancer over the next decade. Sex hormones are not associated with incident prostate or colorectal cancer. Further studies are warranted to determine if similar associations of sex hormones with lung cancer are present in other populations and to investigate potential underlying mechanisms.
KeywordsLung Cancer Prostate Cancer Androgen Receptor Luteinising Hormone Standard Deviation Increase
We thank the staff of the Pathwest Laboratory Medicine, Fremantle, and the Royal Perth Hospitals, Perth, the ANZAC Research Institute, Sydney, the Data Linkage Unit, Health Department of Western Australia, for their assistance. We especially thank all the men and staff who participated in the Western Australian Abdominal Aortic Aneurysm Program and the Health In Men Study.
Compliance with Ethical Standards
The Human Research Ethics Committee of the University of Western Australia approved the study protocol, and all men provided written informed consent to participate in the study.
Grants and Funding
Hormone assays were funded by research grants from the Fremantle Hospital Medical Research Foundation, Fremantle Hospital, Western Australia, and the Ada Bartholomew Medical Research Trust, University of Western Australia. The Health In Men Study was funded by Project Grants 279408, 379600, 403963, 513823, 634492, 1045710 and 1060557 from the National Health and Medical Research Council of Australia. Yi X. Chan is supported by the Warren Jones/University of Western Australia Postgraduate Scholarship.
Conflict of Interest
The authors declare that they have no conflict of interest.
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