Although there is abundant biologic evidence implicating a pivotal role of androgens in the development of prostate cancer, epidemiologic data to date are inconclusive (1-3). Methodological limitations, including intra-person and laboratory variation and timing of measurement, could, in part, contribute to the mixed results. To provide insights and directions for future studies, this presentation briefly reviews current perspectives on hormones and prostate cancer, discusses reasons for inconsistent results in epidemiologic studies, summarizes methodological issues related to the validity of serum-based studies, and provides specific suggestions for future studies. Since there are several metaanalyses and reviews on hormones and prostate cancer (2, 4-7), this review will focus primarily on conceptual and methodological issues. In addition to androgens, the role of several other hormones, including estrogen, insulin, and leptin, and sex hormone-binding globulin will be discussed briefly. Insulin-like growth factors and vitamin D are not discussed here since they are reviewed in two separate presentations in this special issue of Epidemiologic Reviews; these presentations are titled "Insulin-like Growth Factor and Prostate Cancer" and "Dairy Products, Calcium, and Vitamin D and Risk of Prostate Cancer." Studies of genetic polymorphisms involved in androgen biosynthesis, metabolism, and transport are not reviewed, but some of the genetic markers are mentioned briefly in the context of future studies. A more indepth review of these hormone-related polymorphisms is provided in the presentation titled "Molecular Epidemiology of Hormone-metabolic Loci in Prostate Cancer" in this issue of Epidemiologic Reviews. In addition, a comprehensive review of hormones and hormone-related genes is presented elsewhere (3).
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Ann W. Hsing (2001) studied this question.