madman
Super Moderator
3.2 Aetiology and risk factors for prostate cancer
A wide variety of endogenous and exogenous/environmental factors have been discussed as being associated with the risk of developing PCa, or as being aetiologically important for the progression from latent to clinical PCa [14]. As previously discussed, there is likely a racial factor involved, but Asians who immigrated to the USA have approximately half the risk of PCa when compared to their US born Asian-descendant counterparts, implying a role for environmental and/or dietary factors [15]. These guidelines divide the risk factors into hereditary, such as ethnicity, family history and known genetic mutations, in which direct heritance of the risk factor is more obvious and direct, and non-hereditary, such as dietary and medical factors as well as metabolic syndrome and obesity, in which there may well be hereditary components, but they are more indirect.
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3.2.2.3.2 Testosterone
Hypogonadal men receiving testosterone supplements do not have an increased risk of developing PCa [84]. A pooled analysis showed that men with very low concentrations of free testosterone (lowest 10%) have a below average risk (OR: 0.77) of PCa [85]. Furthermore, although the evidence is limited, men who are managed expectantly for PCa, or who received radical curative therapy, do not have worse outcomes when receiving testosterone supplementation, despite a theoretical higher risk of progression after correction of the hypogonadal situation [86].
A wide variety of endogenous and exogenous/environmental factors have been discussed as being associated with the risk of developing PCa, or as being aetiologically important for the progression from latent to clinical PCa [14]. As previously discussed, there is likely a racial factor involved, but Asians who immigrated to the USA have approximately half the risk of PCa when compared to their US born Asian-descendant counterparts, implying a role for environmental and/or dietary factors [15]. These guidelines divide the risk factors into hereditary, such as ethnicity, family history and known genetic mutations, in which direct heritance of the risk factor is more obvious and direct, and non-hereditary, such as dietary and medical factors as well as metabolic syndrome and obesity, in which there may well be hereditary components, but they are more indirect.
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3.2.2.3.2 Testosterone
Hypogonadal men receiving testosterone supplements do not have an increased risk of developing PCa [84]. A pooled analysis showed that men with very low concentrations of free testosterone (lowest 10%) have a below average risk (OR: 0.77) of PCa [85]. Furthermore, although the evidence is limited, men who are managed expectantly for PCa, or who received radical curative therapy, do not have worse outcomes when receiving testosterone supplementation, despite a theoretical higher risk of progression after correction of the hypogonadal situation [86].
