Table 2.
Association between sex hormone quartile (a) and lethal prostate cancer (defined as development of metastases or cancer-specific mortality) (b) and total mortality; combined cohort of the Health Professionals Follow-up Study and the Physicians’ Health Study (n = 963), 1982–2010
| (a)
| |||||
|---|---|---|---|---|---|
| Quartile5 | ptrend | ||||
| Q1 (low) | Q2 | Q3 | Q4 (high) | ||
| Total T | |||||
| No. events/cases | 36/240 | 39/240 | 45/243 | 28/240 | |
| HR11 (95% CI) | 1.00 | 1.09 (0.70–1.72) | 1.25 (0.81–1.94) | 0.77 (0.47–1.26) | 0.48 |
| HR22 (95% CI) | 1.00 | 1.29 (0.81–2.07) | 1.42 (0.91–2.23) | 0.94 (0.56–1.58) | 0.97 |
| HR33 (95% CI) | 1.00 | 1.38 (0.86–2.23) | 1.18 (0.74–1.88) | 0.98 (0.58–1.67) | 0.83 |
| SHBG | |||||
| No. events/cases | 35/238 | 38/243 | 32/242 | 43/240 | |
| HR11 (95% CI) | 1.00 | 1.12 (0.71–1.77) | 0.86 (0.53–1.38) | 1.25 (0.80–1.96) | 0.55 |
| HR22 (95% CI) | 1.00 | 1.26 (0.79–2.01) | 0.93 (0.57–1.51) | 1.46 (0.92–2.31) | 0.26 |
| HR33 (95% CI) | 1.00 | 1.02 (0.63–1.65) | 0.69 (0.42–1.14) | 0.95 (0.58–1.54) | 0.50 |
| SHBG-adjusted T4 | |||||
| No. events/cases | 36/240 | 39/240 | 45/243 | 28/240 | |
| HR11 (95% CI) | 1.00 | 0.99 (0.62–1.57) | 1.04 (0.65–1.66) | 0.53 (0.29–0.97) | 0.09 |
| HR22 (95% CI) | 1.00 | 1.16 (0.72–1.87) | 1.17 (0.72–1.89) | 0.65 (0.36–1.20) | 0.27 |
| HR33 (95% CI) | 1.00 | 1.39 (0.85–2.27) | 1.19 (0.72–1.96) | 0.99 (0.54–1.82) | 0.89 |
| Free T6 | |||||
| No. events/cases | 23/172 | 20/174 | 20/174 | 18/173 | |
| HR11 (95% CI) | 1.00 | 0.81 (0.44–1.47) | 0.93 (0.51–1.71) | 0.81 (0.44–1.51) | 0.63 |
| HR22 (95% CI) | 1.00 | 1.08 (0.57–2.04) | 1.24 (0.66–2.34) | 1.10 (0.57–2.12) | 0.69 |
| HR33 (95% CI) | 1.00 | 1.53 (0.80–2.94) | 1.36 (0.69–2.66) | 1.50 (0.76–2.96) | 0.30 |
| DHT7 | |||||
| No. events/cases | 32/175 | 28/187 | 31/180 | 35/181 | |
| HR11 (95% CI) | 1.00 | 0.82 (0.49–1.36) | 0.89 (0.54–1.46) | 1.06 (0.65–1.72) | 0.74 |
| HR22 (95% CI) | 1.00 | 0.89 (0.53–1.49) | 1.02 (0.61–1.70) | 1.22 (0.74–2.01) | 0.37 |
| HR33 (95% CI) | 1.00 | 0.80 (0.47–1.37) | 0.82 (0.48–1.39) | 1.22 (0.72–2.04) | 0.46 |
| AAG | |||||
| No. events/cases | 35/238 | 43/241 | 35/243 | 35/239 | |
| HR11 (95% CI) | 1.00 | 1.17 (0.75–1.83) | 0.95 (0.59–1.52) | 1.06 (0.66–1.71) | 0.96 |
| HR22 (95% CI) | 1.00 | 1.24 (0.79–1.95) | 0.99 (0.62–1.59) | 1.10 (0.69–1.77) | 0.94 |
| HR33 (95% CI) | 1.00 | 1.14 (0.71–1.82) | 0.96 (0.59–1.56) | 1.04 (0.64–1.70) | 0.93 |
| E2 | |||||
| No. events/cases | 31/234 | 40/242 | 33/243 | 44/244 | |
| HR11 (95% CI) | 1.00 | 1.28 (0.80–2.04) | 1.04 (0.64–1.70) | 1.47 (0.93–2.33) | 0.19 |
| HR22 (95% CI) | 1.00 | 1.24 (0.77–1.98) | 1.00 (0.61–1.64) | 1.32 (0.83–2.11) | 0.40 |
| HR33 (95% CI) | 1.00 | 1.27 (0.79–2.05) | 1.34 (0.81–2.23) | 1.38 (0.86–2.21) | 0.19 |
|
| |||||
|
(b)
| |||||
| Quartile5 | |||||
| Q1 (low) | Q2 | Q3 | Q4 (high) | ptrend | |
|
| |||||
| Total T | |||||
| No. events/cases | 108/240 | 106/240 | 110/243 | 97/240 | |
| HR11 (95% CI) | 1.00 | 1.01 (0.77–1.32) | 1.03 (0.79–1.34) | 0.87 (0.66–1.15) | 0.37 |
| HR22 (95% CI) | 1.00 | 1.18 (0.89–1.56) | 1.17 (0.89–1.54) | 1.08 (0.81–1.44) | 0.60 |
| HR33 (95% CI) | 1.00 | 1.16 (0.88–1.54) | 1.07 (0.81–1.41) | 1.07 (0.80–1.44) | 0.78 |
| SHBG | |||||
| No. events/cases | 100/238 | 107/243 | 97/242 | 117/240 | |
| HR11 (95% CI) | 1.00 | 1.13 (0.86–1.49) | 0.86 (0.65–1.14) | 1.12 (0.86–1.47) | 0.84 |
| HR22 (95% CI) | 1.00 | 1.25 (0.95–1.66) | 0.91 (0.68–1.21) | 1.29 (0.98–1.70) | 0.33 |
| HR33 (95% CI) | 1.00 | 1.19 (0.90–1.58) | 0.83 (0.62–1.11) | 1.14 (0.85–1.51) | 0.99 |
| SHBG-adj T4 | |||||
| No. events/cases | 108/240 | 106/240 | 110/243 | 97/240 | |
| HR11 (95% CI) | 1.00 | 0.96 (0.73–1.26) | 0.93 (0.70–1.24) | 0.72 (0.51–1.01) | 0.08 |
| HR22 (95% CI) | 1.00 | 1.11 (0.84–1.48) | 1.05 (0.79–1.41) | 0.89 (0.63–1.26) | 0.52 |
| HR33 (95% CI) | 1.00 | 1.14 (0.86–1.52) | 1.03 (0.77–1.39) | 1.01 (0.71–1.44) | 0.91 |
| Free T6 | |||||
| No. events/cases | 73/172 | 61/174 | 58/174 | 50/173 | |
| HR11 (95% CI) | 1.00 | 0.74 (0.53–1.04) | 0.89 (0.63–1.26) | 0.72 (0.50–1.03) | 0.15 |
| HR22 (95% CI) | 1.00 | 0.92 (0.65–1.32) | 1.15 (0.80–1.66) | 0.94 (0.64–1.37) | 0.96 |
| HR33 (95% CI) | 1.00 | 0.99 (0.69–1.43) | 1.15 (0.80–1.67) | 0.99 (0.67–1.46) | 0.83 |
| DHT7 | |||||
| No. events/cases | 81/175 | 94/187 | 84/180 | 94/181 | |
| HR11 (95% CI) | 1.00 | 1.07 (0.80–1.45) | 0.89 (0.65–1.21) | 0.99 (0.73–1.34) | 0.65 |
| HR22 (95% CI) | 1.00 | 1.23 (0.91–1.66) | 1.02 (0.74–1.40) | 1.17 (0.86–1.59) | 0.56 |
| HR33 (95% CI) | 1.00 | 1.27 (0.93–1.73) | 0.98 (0.71–1.36) | 1.25 (0.91–1.72) | 0.43 |
| AAG | |||||
| No. events/cases | 108/238 | 106/241 | 100/243 | 107/239 | |
| HR11 (95% CI) | 1.00 | 0.92 (0.70–1.20) | 0.89 (0.68–1.17) | 1.19 (0.91–1.56) | 0.29 |
| HR22 (95% CI) | 1.00 | 0.98 (0.75–1.29) | 0.94 (0.71–1.24) | 1.23 (0.94–1.62) | 0.21 |
| HR33 (95% CI) | 1.00 | 1.02 (0.77–1.35) | 0.94 (0.70–1.24) | 1.19 (0.90–1.57) | 0.34 |
| E2 | |||||
| No. events/cases | 108/234 | 106/242 | 94/243 | 113/244 | |
| HR11 (95% CI) | 1.00 | 1.00 (0.77–1.31) | 0.88 (0.67–1.17) | 1.18 (0.91–1.54) | 0.39 |
| HR22 (95% CI) | 1.00 | 0.98 (0.75–1.28) | 0.86 (0.65–1.14) | 1.09 (0.83–1.43) | 0.75 |
| HR33 (95% CI) | 1.00 | 0.93 (0.71–1.23) | 0.84 (0.63–1.12) | 1.09 (0.83–1.43) | 0.71 |
AAG = androstanediol glucuronide; BMI = body mass index; CI = confidence interval; DHT = dihydrotestosterone; E2 = estradiol; HPFS = Health Professionals Follow-up Study; HR = hazard ratio; SHBG = sex hormone binding globulin; T = testosterone.
PHS = Physicians’ Health Study; SHBG = sex hormone binding globulin; T = testosterone.
HR1: adjusted for age at diagnosis.
HR2: adjusted for age at diagnosis, BMI, physical activity, smoking status.
HR3: adjusted for age at diagnosis, BMI, physical activity, smoking status, Gleason score, and TNM stage.
HRs as above but further adjusted for SHBG using a batch-adjusted continuous measure of SHBG.
Quartiles calculated separately for each batch to control for interassay variation.
Free testosterone not measured in PHS.
DHT data not available for third HPFS batch.