Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Clinical Research

Second to fourth digit ratio and prostate cancer severity

Prostate Cancer and Prostatic Diseases volume 16, pages 107–110 (2013)Cite this article

Subjects

Abstract

Background:

The ratio of the second to the fourth digit (2D:4D ratio) is a sexually dimorphic trait established in utero that differs between ethnic groups. It is associated with prenatal androgen exposure, and studies have evaluated the ratio as a marker for certain traits and disease states known to be associated with higher levels of in utero androgens, such as prostate cancer. There are currently no screening tools that stratify men with prostate cancer according to the severity of their disease. This study aims to investigate the 2D:4D ratio as a potential marker for prostate cancer severity. Our hypothesis was that lower digit ratios, representing higher in utero androgen exposure, would be associated with more severe disease.

Methods:

Measurements were taken of the second and fourth digits of the right hand of male patients diagnosed with prostate cancer. Gleason score, presence of metastasis, family history, age at diagnosis and race were recorded. The distribution of demographic and other patient characteristics were compared with digit ratios to determine relationships.

Results:

African-American men with prostate cancer are 3.70 times more likely to have a low 2D:4D digit ratio than Caucasian men with prostate cancer (95% confidence interval: 1.98, 6.92; P<0.0001). There were no statistically significant differences in the presence of metastasis, Gleason score, family history or age at diagnosis by digit ratio.

Conclusion:

2D:4D ratio shows strong differences between African-Americans and Caucasians; however, it does not correlate with disease severity in men already diagnosed with prostate cancer. Although this is a small population sample with possible confounding factors, it does not provide evidence to support the hypothesis that prenatal androgens affect prostate cancer grade or progression.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Phelps VR . Relative index finger length as a sex influenced trait in man. Am J Hum Genet 1956; 4: 72–89.

    Google Scholar 

  2. Manning JT, Barley L, Walton J, Lewis-Jones DI, Trivers RL, Singh D et al. The 2nd:4th digit ratio, sexual dimorphism, population differences, and reproductive success. Evidence for sexually antagonistic genes? Evol Hum Behav 2000; 21: 163–183.

    Article  CAS  PubMed  Google Scholar 

  3. Heinlein CA, Chang C . Androgen receptor (AR) coregulators: an overview. Endocr Rev 2002; 23: 175–200.

    Article  CAS  PubMed  Google Scholar 

  4. Honekopp J, Watson S . Meta-analysis of digit ratio 2D:4D shows greater sex difference in the right hand. Am J Hum Biol 2010; 22: 619–630.

    Article  PubMed  Google Scholar 

  5. Lutchmaya S, Baron-Cohen S, Raggatt P, Knickmeyer R, Manning JT . 2nd to 4th digit ratios, fetal testosterone and estradiol. Early Hum Dev 2004; 77: 23–28.

    Article  CAS  PubMed  Google Scholar 

  6. McIntyre MH, Cohn BA, Ellison PT . Sex dimorphism in digital formulae of children. Am J Phys Anthropol 2006; 129: 143–150.

    Article  PubMed  Google Scholar 

  7. Manning JT, Baron-Cohen S, Wheelwright S, Sanders G . The 2nd to 4th digit ratio and autism. Dev Med Child Neurol 2001; 43: 160–164.

    Article  CAS  PubMed  Google Scholar 

  8. Collaer ML, Reimers S, Manning JT . Visuospatial performance on an internet line judgment task and potential hormonal markers: sex, sexual orientation, and 2D:4D. Arch Sex Behav 2007; 36: 177–192.

    Article  PubMed  Google Scholar 

  9. Endogenous Hormones and Prostate Cancer Collaborative Group Roddam AW, Allen NE, Appleby P, Key TJ . Endogenous sex hormones and prostate cancer: a collaborative analysis of 18 prospective studies. J Natl Cancer Inst 2008; 100: 170–183.

    Article  PubMed Central  Google Scholar 

  10. Jung H, Kim KH, Yoon SJ, Kim TB . Second to fourth digit ratio: a predictor of prostate-specific antigen level and the presence of prostate cancer. BJU Int 2011; 107: 591–596.

    Article  PubMed  Google Scholar 

  11. Rahman AA, Lophatananon A, Stewart-Brown S, Harriss D, Anderson J, Parker T et al. Hand pattern indicates prostate cancer risk. Br J Cancer 2011; 104: 175–177.

    Article  CAS  PubMed  Google Scholar 

  12. Draisma G, Boer R, Otto SJ, van der Cruijsen IW, Damhuis RA, Schröder FH et al. Lead times and over detection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst 2003; 95: 868–878.

    Article  PubMed  Google Scholar 

  13. Albertsen PC, Hanley JA, Fine J . 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA 2005; 293: 2095–2101.

    Article  CAS  Google Scholar 

  14. Kondo T, Zakany J, Innis JW, Duboule D . Of fingers, toes and penises. Nature 1997; 390: 29.

    Article  CAS  PubMed  Google Scholar 

  15. Voracek M, Manning JT . Length of fingers and penis are related through fetal Hox gene expression. Urology 2003; 62: 201.

    Article  PubMed  Google Scholar 

  16. Zheng ZH, Cohn MJ . Developmental basis of sexually dimorphic digit ratios. Proc Natl Acad Sci 2011; 108: 16289–16294.

    Article  CAS  PubMed  Google Scholar 

  17. Brown WM, Hines M, Fane BA, Breedlove SM . Masculinized finger length patterns in human males and females with congenital adrenal hyperplasia. Horm Behav 2002; 42: 380–386.

    Article  PubMed  Google Scholar 

  18. Ökten A, Kalyoncu M, Yaris N . The ratio of second- and fourth digit lengths and congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Early Hum Dev 2002; 70: 47–54.

    Article  PubMed  Google Scholar 

  19. Henderson BE, Bernstein L, Ross RK, Depue RH, Judd HL . The early in utero estrogen and testosterone environment of blacks and whites: potential effects on male offspring. Br J Cancer 1988; 57: 216–218.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Muller DC, Giles GG, Manning JT, Hopper JL, English DR, Severi G . Second to fourth digit ratio (2D:4D) and prostate cancer risk in the Melbourne Collaborative Cohort Study. Br J Cancer 2011; 105: 438–440.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Peters M, Tan U, Kang Y, Teixiera L, Mandal M . Sex-specific finger-lengthpatterns linked to behavioral variables: consistency across various human populations. Percept Mot Skills 2002; 94: 171–181.

    Article  CAS  PubMed  Google Scholar 

  22. Peters N, Armstrong K . Racial differences in prostate cancer treatment outcomes: a systematic review. Cancer Nurs 2005; 28: 108–118.

    Article  PubMed  Google Scholar 

  23. Ronalds G, Phillips DI, Godfrey KM, Manning JT . The ratio of second to fourth digit lengths: a marker of impaired fetal growth? Early Hum Dev 2002; 68: 21–26.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Tulane University School of Medicine, New Orleans, LA, USA

    M Waters, C M Rebholz, B Wood, A Kuske & O Sartor

  2. Department of Anthropology, University of Central Florida, Orlando, FL, USA

    M McIntyre

  3. Department of Medicine and Urology, Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA, USA

    O Sartor

Authors
  1. M Waters
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C M Rebholz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B Wood
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A Kuske
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M McIntyre
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. O Sartor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to O Sartor.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Waters, M., Rebholz, C., Wood, B. et al. Second to fourth digit ratio and prostate cancer severity. Prostate Cancer Prostatic Dis 16, 107–110 (2013). https://doi.org/10.1038/pcan.2012.46

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/pcan.2012.46

Keywords

This article is cited by

Search

Advanced search

Quick links