Long-Term Testosterone Therapy Not Linked to Prostate Cancer

Long-term use of testosterone replacement therapy (TRT) does not increase the risk of prostate cancer, according to a new study from Sweden.

The belief that TRT is linked to prostate cancer is controversial, due to substantial limitations in previous studies, including small sample size, short trial duration, or lack of a control group. Therefore, the authors of the new study wanted to examine the long-term effects of TRT in a large population and whether it impacts prostate cancer risk.
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To conduct their study, the researchers searched 2 large databases in Sweden—the National Prostate Cancer Register (NPCR) and the Prescribed Drug Register—including data from 38,570 patients who were diagnosed with prostate cancer from 2009 to 2012 and 192,838 age-matched controls.

The researchers tracked participants who adhered to TRT for more than 1 year based on filled prescriptions.

After analyzing the data, the researchers found that 284 men with prostate cancer and 1378 men in the control group had filled TRT prescriptions. Multivariate analysis showed no significant association between TRT use and prostate cancer risk.

However, while those using TRT were more likely to have favorable-risk prostate cancer within the first year of TRT use, they also had a lower risk of aggressive disease after 1 year of use compared with the control group.

“TRT use was associated with an early increase in favorable-risk prostate cancer, suggesting a possible detection bias,” the researchers concluded. “However, the finding of a lower risk of aggressive prostate cancer in the long-term among TRT users is a novel finding that warrants further investigation.”

—Amanda Balbi

Reference:

Loeb S, Folkvaljon Y, Damber J-E, Alukal J, Lambe M, Stattin P. Testosterone therapy and prostate cancer risk. Paper presented at: American Urological Association Annual Meeting; May 6-10, 2016; San Diego, CA. http://www.aua2016.org/abstracts/files/presenter_LoebStacy-NewYork-NY.cfm. Accessed May 10, 2016.