Hormones and Cancer

, Volume 9, Issue 6, pp 391–398 | Cite as

Lower Circulating Androgens Are Associated with Overall Cancer Risk and Prostate Cancer Risk in Men Aged 25–84 Years from the Busselton Health Study

  • Yi X. ChanEmail author
  • Matthew W. Knuiman
  • Mark L. Divitini
  • David J. Handelsman
  • John P. Beilby
  • Bu B. Yeap
Original Paper


Androgens, notably testosterone (T), have been implicated in development of several common cancers and prostate cancer; however, precise mechanisms remain unclear. This study assessed prospective associations of serum T, dihydrotestosterone (DHT) and estradiol (E2) with overall cancer (excluding skin cancer), prostate, colorectal and lung cancer risk in 1574 community-dwelling men aged 25–84 years. Sex hormones were assayed using mass spectrometry and men were followed for 20 years with outcomes ascertained using data linkage. Over 20 years, there were 289, 116, 48 and 22 men who developed any cancer, prostate cancer, colorectal cancer and lung cancer, respectively. Androgens in the lowest quartile were associated with an increased overall cancer risk (HR = 1.36, 95% CI 1.05–1.76, p = 0.020 for T; and HR = 1.30, 95% CI 1.00–1.69, p = 0.049 for DHT comparing the lowest vs other quartiles). T in the lowest quartile was associated with an increased risk of prostate cancer (HR = 1.53, 95% CI 1.02–2.29, p = 0.038 comparing the lowest vs other quartiles). The association between androgens and overall cancer risk remained similar after excluding prostate cancer outcomes; however, results were not significant. There were no associations of T, DHT or E2 with colorectal or lung cancer risk; however, LH in the highest quartile was associated with an increased risk of lung cancer (HR = 4.55, 95% CI 1.70–12.19, p = 0.003 for the highest vs other quartiles). Whether T is a biomarker of poor health in men with any cancer or prostate cancer requires further confirmation as does the nature and mechanism of the association of a high LH with future lung cancer.


Testosterone Dihydrotestosterone Estradiol Cancer incidence 



The authors thank the staff of the Western Australian Data Linkage Branch, the Cancer Registry and the Registrar General’s Office for their assistance in providing linked data. The authors especially thank the Busselton men who took part in the survey and the Busselton Population Medical Research Institute for access to the survey data and specimens.


This study was funded by Project Grant 1021326 from the National Health and Medical Research Council of Australia. BBY is the recipient of a clinical investigator award from the Sylvia and Charles Viertel Charitable Foundation, NSW, Australia. The 1994/1995 Busselton Health Survey was supported and funded by the Health Promotion Foundation of Western Australia. The funding sources had no involvement in the planning, analysis and writing of the manuscript.

Supplementary material

12672_2018_346_MOESM1_ESM.docx (17 kb)
ESM 1 (DOCX 17 kb)
12672_2018_346_MOESM2_ESM.docx (53 kb)
ESM 2 (DOCX 53 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.The Medical SchoolUniversity of Western AustraliaCrawleyAustralia
  2. 2.Department of Endocrinology and DiabetesFiona Stanley HospitalMurdochAustralia
  3. 3.School of Population and Global HealthUniversity of Western AustraliaCrawleyAustralia
  4. 4.ANZAC Research InstituteUniversity of SydneySydneyAustralia
  5. 5.PathWest Laboratory MedicineSir Charles Gairdner HospitalNedlandsAustralia
  6. 6.School of Pathology and Laboratory MedicineUniversity of Western AustraliaCrawleyAustralia

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