Greater use of testosterone therapy (TTh) is associated with a lower risk for prostate cancer (PCa) in men without diabetes, according to study findings published in Clinical Endocrinology.

Of 189,491 men ages 40 to 60 years in the IBM MarketScan Commercial Database who received testosterone therapy, 1424 were diagnosed with PCa. Among men without diabetes, those who received more than 12 testosterone injections had a 33% lower risk for PCa than men who received only 1 to 2 injections, in adjusted analyses, David Lopez, DrPh, MPH, MS, of University of Texas Medical Branch at Galveston, and colleagues reported. Likewise, men with more than a 330-day supply of testosterone gel had 45% lower risks for PCa than men with a 60-day supply or less. The investigators found no significant association between testosterone use and PCa in men with diabetes.

Since their results showed a significant inverse relationship between TTh and PCa only among non-diabetics, “we could hypothesize that diabetes has a stronger effect on increasing probability of PCa than the beneficial effects of TTh,” Dr Lopez’s team wrote. “Therefore, diabetes overwhelmed the beneficial effects provided by TTh use on reducing the association with PCa among diabetics and thus no statistical association was found in this group. Yet, this latter statement is only hypothetical.”

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The investigators adjusted for age, Charlson Comorbidity Index, PSA, hypogonadism, diabetes, hypertension, malaise and fatigue, osteoporosis, testicular dysfunction, erectile dysfunction, depressive disorder, anterior pituitary disorder, decreased libido, and use of insulin and statins but not race or body mass index, which is a limitation.

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Lopez DS, Huang D, Tsilidis KK, et al. Association of the extent of therapy with prostate cancer in those receiving testosterone therapy in a US commercial insurance claims database [published online September 9, 2019]. Clin Endocrinol. doi:10.1111/cen.14093