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Epidemiology

Testosterone therapy and cancer risks among men in the SEER-Medicare linked database

British Journal of Cancer volume 128, pages 48–56 (2023)Cite this article

Subjects

Abstract

Background

We examined associations between two forms of testosterone therapy (TT) and risks of seven cancers among men.

Methods

SEER-Medicare combines cancer registry data from the Surveillance, Epidemiology, and End Results programme with Medicare claims. Our population-based case–control study included incident cancer cases diagnosed between 1992–2015: prostate (n = 130,713), lung (n = 105,466), colorectal (n = 56,433), bladder (n = 38,873), non-Hodgkin lymphoma (n = 17,854), melanoma (n = 14,241), and oesophageal (n = 9116). We selected 100,000 controls from a 5% random sample of Medicare beneficiaries and used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI).

Results

TT was associated with lower risk of distant-stage prostate cancer (injection/implantation OR = 0.72, 95% CI: 0.60–0.86; topical OR = 0.50, 95% CI: 0.24–1.03). We also observed inverse associations for distant-stage colorectal cancer (injection/implantation OR = 0.75, 95% CI: 0.62–0.90; topical OR = 0.11, 95% CI: 0.05–0.24). Risks of distant-stage colorectal and prostate cancers decreased with time after initiating TT by injection/implantation. By contrast, TT was positively associated with distant-stage melanoma (injection/implantation OR = 1.70, 95% CI: 1.37–2.11). TT was not associated with bladder cancer, oesophageal cancer, lung cancer or non-Hodgkin lymphoma.

Conclusion

TT was inversely associated with distant-stage prostate and colorectal cancers but was positively associated with distant-stage melanoma. These observations may suggest an aetiologic role for TT or the presence of residual confounding.

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Data availability

SEER-Medicare data are not publicly available. Data requests are managed and approved by Information Management Services, Inc.

Code availability

The SEER-Medicare data and statistical code used to generate the results herein are not publicly available. Request for data and statistical code are managed and approved by Information Management Services, Inc.

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Acknowledgements

The authors acknowledge and thank the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program and the Centers for Medicare and Medicaid Services. We also acknowledge and thank the programming team from Information Management Services (IMS). This work was supported by National Cancer Institute’s Intramural Research Program.

Funding

This work was supported by Intramural Research Funds of the Division of Cancer Epidemiology and Genetics (DCEG) of the National Cancer Institute, Department of Health and Human Services, USA.

Author information

Authors and Affiliations

  1. Integrative Tumor Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA

    Eboneé N. Butler & Marie C. Bradley

  2. University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, NC, USA

    Eboneé N. Butler

  3. Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA

    Cindy Ke Zhou & Michael B. Cook

  4. Information Management Services, Inc, Calverton, MD, USA

    Michael Curry

  5. Cancer Epidemiology Research Group, Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, UK

    Úna McMenamin & Christopher Cardwell

  6. Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA

    Barry I. Graubard

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Contributions

Conception and design: ENB, CKZ and MBC. Data analysis and interpretation: all authors. Manuscript writing: all authors. Final approval of manuscript: all authors.

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Correspondence to Eboneé N. Butler.

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Butler, E.N., Zhou, C.K., Curry, M. et al. Testosterone therapy and cancer risks among men in the SEER-Medicare linked database. Br J Cancer 128, 48–56 (2023). https://doi.org/10.1038/s41416-022-02019-7

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