Circulating steroid hormones in prostate carcinogenesis. Part 1 - Androgens

Area of Science:

• Endocrinology
• Oncology
• Epidemiology

Background:

• Prostate cancer (PCa) risk varies among populations, with potential links to circulating steroid hormones.
• Previous studies have yielded inconsistent findings regarding steroid levels and PCa development or progression.

Purpose of the Study:

• To review and synthesize existing literature on circulating steroid levels associated with prostate cancer.
• To evaluate steroid profiles in different risk groups, pre-diagnosis, and at diagnosis.
• To assess the reliability of current steroid measurement methodologies.

Main Methods:

• Systematic review of chronological bibliographic reports on circulating steroid levels and PCa.
• Comparison of steroid levels in high-risk (e.g., African-Americans) versus lower-risk populations.
• Analysis of nested case-control studies examining pre-diagnostic steroid levels.
• Review of studies correlating steroid levels at diagnosis with PCa aggressiveness.

Main Results:

• Higher testosterone levels reported in young African-American men, with differences diminishing with age.
• Inconsistent findings for dihydrotestosterone (DHT) due to assay difficulties.
• Trend towards decreased sex hormone-binding globulin (SHBG) and increased bioavailable testosterone in PCa.
• Lower testosterone levels observed in aggressive PCa, with normalization post-prostatectomy.

Conclusions:

• Circulating testosterone levels may be associated with PCa aggressiveness, showing decreases in advanced stages.
• Current reliance on immunological assays for steroid measurement in epidemiological studies is problematic.
• Mass spectrometry coupled with chromatography is recommended for more accurate and reliable steroid quantification in future studies.