Testosterone therapy in hypogonadal men and potential prostate cancer risk: a systematic review

• Published in: International journal of impotence research Vol. 21; no. 1; pp. 9 - 23
• Main Authors: Shabsigh, R, Crawford, E D, Nehra, A, Slawin, K M
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-01-2009; Nature Publishing Group
• Subjects: Antigens; Biological and medical sciences; Care and treatment; Clinical Trials as Topic; Complications and side effects; Diagnosis; Gynecology. Andrology. Obstetrics; Health aspects; Humans; Hypogonadism; Hypogonadism - complications; Hypogonadism - drug therapy; Male; Male genital diseases; Medical sciences; Medicine; Medicine & Public Health; Nephrology. Urinary tract diseases; Prostate cancer; Prostatic Neoplasms - chemically induced; Prostatic Neoplasms - complications; Reproductive Medicine; review; Risk Factors; rology; Systematic review; Testosterone; Testosterone - adverse effects; Testosterone - therapeutic use; Tumors; Tumors of the urinary system; Urinary tract. Prostate gland; Urology; United States; testosterone; testosterone therapy; prostate cancer; hypogonadism; systematic review; prostate-specific antigen; Human; Andrology; Urinary system disease; Androgen; Prostate disease; Male; Malignant tumor; Review; Hypogonadism; Genital diseases; Prostate specific antigen; Testosterone; Treatment; Risk factor; testosterone therapy; Male genital diseases; Prostate cancer; Bibliographic review; Cancer
• ISSN: 0955-9930; 1476-5489
• DOI: 10.1038/ijir.2008.31

This paper provides a systematic review of the literature about prostate cancer risk associated with testosterone therapy for hypogonadism. A comprehensive search of MEDLINE, EMBASE and other resources was conducted to identify articles that highlight occurrences of prostate cancer in men receiving testosterone therapy for hypogonadism treatment. Articles that met study inclusion criteria were assessed for causality between testosterone treatment and prostate cancer, increased prostate-specific antigen or abnormal digital rectal examination findings. Of 197 articles relating to testosterone therapy, 44 met inclusion criteria: 11 placebo-controlled, randomized studies; 29 non-placebo-controlled studies of men with no prostate cancer history; and 4 studies of hypogonadal men with history of prostate cancer. Of studies that met inclusion criteria, none demonstrated that testosterone therapy for hypogonadism increased prostate cancer risk or increased Gleason grade of cancer detected in treated vs untreated men. Testosterone therapy did not have a consistent effect on prostate-specific antigen levels.