Independent and joint effects of testosterone replacement therapy and statins use on the risk of prostate cancer among White, Black and Hispanic men

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Cancer Prev Res (Phila). 2021 Apr 20:canprevres.0040.2021. doi: 10.1158/1940-6207.CAPR-21-0040. Online ahead of print.


The associations of testosterone therapy (TTh) and statins use with prostate cancer (PCa) remain conflicted. However, the joint effects of TTh and statins use on the incidence of PCa, stage and grade at diagnosis, and PCa-specific mortality (PCSM) have not been studied. We identified White (N=74181), Black (N=9157) and Hispanic (N=3313) men diagnosed with PCa in SEER-Medicare 2007-2016. Pre-diagnostic prescription of TTh and statins was ascertained for this analysis. Weighted multivariable-adjusted conditional logistic and Cox proportional hazards models evaluated the association of TTh and statins with PCa, including statistical interactions between TTh and statins. We found that TTh (OR = 0.74, 95% CI: 0.68 – 0.81) and statins (OR = 0.77, 95% CI: 0.0.75 – 0.88) were inversely associated with incident PCa. Similar inverse associations were observed with high-grade and advanced PCa in relation to TTh and statins use. TTh plus statins was inversely associated with incident PCa (OR = 0.53, 95% CI: 0.48 – 0.60), high-grade (OR = 0.43, 95% CI: 0.37 – 0.49) and advanced PCa (OR = 0.44, 95% CI: 0.35 – 0.55). Similar associations were present in White and Black men, but among Hispanics statins were associated with PCSM. Pre-diagnostic use of TTh or statins, independent or combined, was inversely associated with incident and aggressive PCa overall and in NHW and NHB men. Findings for statins and aggressive PCa are consistent with previous studies. Future studies need to confirm the independent inverse association of TTh and the joint inverse association of TTh plus statins on risk of PCa in understudied populations.

PMID:33879532 | DOI:10.1158/1940-6207.CAPR-21-0040