Deparment of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas.
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
Cancer Prev Res (Phila). 2021 Jul;14(7):719-728. doi: 10.1158/1940-6207.CAPR-21-0040. Epub 2021 Apr 20.
The associations of testosterone therapy (TTh) and statins use with prostate cancer remain conflicted. However, the joint effects of TTh and statins use on the incidence of prostate cancer, stage and grade at diagnosis, and prostate cancer-specific mortality (PCSM) have not been studied.We identified White ( = 74,181), Black ( = 9,157), and Hispanic ( = 3,313) men diagnosed with prostate cancer in SEER-Medicare 2007-2016. Prediagnostic 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 prostate cancer, 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 prostate cancer. Similar inverse associations were observed with high-grade and advanced prostate cancer in relation to TTh and statins use. TTh plus statins was inversely associated with incident prostate cancer (OR = 0.53; 95% CI, 0.48-0.60), high-grade (OR = 0.43; 95% CI, 0.37-0.49), and advanced prostate cancer (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.Prediagnostic use of TTh or statins, independent or combined, was inversely associated with incident and aggressive prostate cancer overall and in NHW and NHB men. Findings for statins and aggressive prostate cancer 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 prostate cancer in understudied populations. PREVENTION RELEVANCE: The study investigates a potential interaction between TTh and statin and its effect on incident and aggressive prostate cancer in men of different racial and ethnic backgrounds. These results suggest that among NHW and non-Hispanic Black men TTh plus statins reduced the odds of incident prostate cancer, high-grade and advance stage prostate cancer.
睾酮治疗（TTh）和他汀类药物使用与前列腺癌之间的关联仍存在争议。然而，尚未研究 TTh 和他汀类药物联合使用对前列腺癌的发病率、诊断时的分期和分级以及前列腺癌特异性死亡率（PCSM）的影响。我们在 SEER-Medicare 2007-2016 年期间确定了被诊断患有前列腺癌的白人（=74181）、黑人（=9157）和西班牙裔（=3313）男性。这项分析确定了 TTh 和他汀类药物的预测性处方。加权多变量调整条件逻辑回归和 Cox 比例风险模型评估了 TTh 和他汀类药物与前列腺癌之间的关联，包括 TTh 和他汀类药物之间的统计学相互作用。我们发现 TTh（OR=0.74；95%CI，0.68-0.81）和他汀类药物（OR=0.77；95%CI，0.75-0.88）与前列腺癌的发生率呈负相关。在 TTh 和他汀类药物的使用与高级别和晚期前列腺癌之间也观察到类似的负相关。TTh 加他汀类药物与前列腺癌（OR=0.53；95%CI，0.48-0.60）、高级别（OR=0.43；95%CI，0.37-0.49）和晚期前列腺癌（OR=0.44；95%CI，0.35-0.55）的发生率呈负相关。在白人男性和黑人男性中也存在类似的关联，但在西班牙裔人中，他汀类药物与 PCSM 相关。独立或联合使用 TTh 或他汀类药物与前列腺癌的总发病率以及 NHW 和 NHB 男性的侵袭性前列腺癌呈负相关。他汀类药物与侵袭性前列腺癌的研究结果与以前的研究一致。未来的研究需要证实 TTh 的独立负相关和 TTh 加他汀类药物联合使用对研究较少的人群中前列腺癌风险的联合负相关。预防相关性：本研究调查了 TTh 和他汀类药物之间的潜在相互作用及其对不同种族和族裔背景男性中前列腺癌的发生率和侵袭性的影响。这些结果表明，在 NHW 和非西班牙裔黑人男性中，TTh 加他汀类药物降低了前列腺癌、高级别和晚期前列腺癌的发病风险。
