Incidence of prostate cancer in men with testosterone deficiency and a family history of prostate cancer receiving testosterone therapy: a comparative study.

Objective: To investigate the incidence of any PCa diagnosis in men with testosterone deficiency (TD) who have a family history of PCa and were prescribed TTh compared with a control cohort of men with TD with a family history of PCa but who were not prescribed TTh, over a period of 10 years. Methods and analysis: Retrospective cohort study using data from 1 January 2012 to 7 March 2024 (TriNetX database). After meeting the inclusion criteria, 3041 men were analysed: 628 with family history of PCa and TD who received TTh, and 2413 who did not. We used propensity score matching to balance baseline characteristics between cohorts. The main outcomes were the risk of any PCa diagnosis and any active treatment (including radical prostatectomy, androgen deprivation therapy, brachytherapy, radiation and cryoablation) among men with TD who received TTh versus a matched cohort who did not. Results: Over 10 years, the risk of PCa diagnosis did not significantly differ between men who received TTh (6.26%) and those who did not (5.46%), HR 0.81, 95% CI 0.51 to 1.28. Similarly, no significant difference was found in the risk of receiving any active treatment for PCa between those who received TTh (2.73%) and those who did not (3.69%), HR 0.55, 95% CI 0.29 to 1.03. Conclusions: Men with TD and a family history of PCa who were prescribed TTh showed comparable risks of being diagnosed with PCa or receiving any active treatment for PCa, relative to men with analogous TD and family history, but who did not receive TTh.