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Cited by 42Hormonal and reproductive studiesProstate Cancer Treatment and ResearchProstate Cancer Diagnosis and Treatment

Use of testosterone replacement therapy in the United States and its effect on subsequent prostate cancer outcomes

Kaplan, Alan L., Hu, Jim C.·2013·Urology
DOI 10.1016/j.urology.2013.03.049
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Abstract

Objective To assess utilization trends and determine the effect of testosterone replacement therapy on outcomes in men who subsequently developed prostate cancer.Methods We used linked Surveillance, Epidemiology, and End Results-Medicare data to identify 149,354 men diagnosed with prostate cancer from 1992 to 2007. Of those, 2,237 men (1.5%) underwent testosterone replacement therapy before their prostate cancer diagnosis. Propensity scoring methods were used to assess cancer-specific outcomes of testosterone replacement vs no replacement therapy.Results Testosterone replacement was associated with older age at cancer diagnosis, nonwhite race, and higher comorbidity (P <.001). No testosterone vs testosterone before the prostate cancer diagnosis was associated with higher grade (34% vs 30%, P <.0001) and more T4 (6.5% vs 4.3%, P <.0001) tumors. Mortality was decreased in men with ≥2 prostate-specific antigen (PSA) tests in the year before their cancer diagnosis. No significant difference was found between groups in overall survival, cancer-specific survival, or use of salvage androgen-deprivation therapy after initial treatment.Conclusion Through our observational study design, we show that testosterone use was low throughout the study period. Testosterone use was not associated with aggressive prostate cancer and did not affect overall or disease-specific mortality. Although our findings support growing evidence that testosterone replacement is safe with respect to prostate cancer, confirmatory prospective studies are needed.

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Authors
Kaplan, A. L., & Hu, J. C.
Affiliations
University of California, Los Angeles (US)
Corresponding author
Kaplan, Alan L.
ORCID
Hu, Jim C.
Venue
Urology
Publisher
Elsevier BV
Published
2013-08
Volume
82
Issue
2
Pages
321-326
ISSN
0090-4295 (ISSN-L)
DOI
10.1016/j.urology.2013.03.049
OpenAlex
W2119145601
Cited by
42
References
30
Citations by year
2026: 2 · 2024: 2 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 6 · 2015: 9 · 2014: 8
FWCI
6.03
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Urology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Treatment and Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
Keywords
testosterone replacement therapy, prostate cancer, prostate cancer outcomes, cancer-specific mortality, overall survival, tumor grade, prostate-specific antigen testing, androgen deprivation therapy, utilization trends, older men, racial disparities, comorbidities
MeSH terms
Age Factors, Aged, Androgens, Humans, Hypogonadism, Male, Prostatectomy, Prostatic Neoplasms, Radiotherapy, Testosterone, United States, Prostate-Specific Antigen, SEER Program, Hormone Replacement Therapy, Propensity Score, Watchful Waiting

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