Graff, RebeccaMeisner, AllisonAhearn, Thomas UFiorentino, MichelangeloLoda, MassimoGiovannucci, EdwardMucci, LoreleiPettersson, Andreas2017-05-012016Graff, Rebecca E, Allison Meisner, Thomas U Ahearn, Michelangelo Fiorentino, Massimo Loda, Edward L Giovannucci, Lorelei A Mucci, and Andreas Pettersson. 2016. “Pre-diagnostic circulating sex hormone levels and risk of prostate cancer by ERG tumour protein expression.” British Journal of Cancer 114 (8): 939-944. doi:10.1038/bjc.2016.61. http://dx.doi.org/10.1038/bjc.2016.61.http://nrs.harvard.edu/urn-3:HUL.InstRepos:32630716Background: Experimental studies have shown androgen receptor stimulation to facilitate formation of the TMPRSS2:ERG gene fusion in prostate cell lines. No study has tested whether higher pre-diagnostic circulating sex hormone levels in men increase risk of developing TMPRSS2:ERG-positive prostate cancer specifically. Methods: We conducted a nested case–control study of 200 prostate cancer cases and 1057 controls from the Physicians' Health Study and Health Professionals Follow-up Study. We examined associations between pre-diagnostic circulating levels of total testosterone, free testosterone, DHT, androstanediol glucuronide, estradiol, and SHBG and risk of prostate cancer by TMPRSS2:ERG status. TMPRSS2:ERG was estimated by ERG immunohistochemistry. We used multivariable unconditional polytomous logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for risk of ERG-positive (n=94) and, separately, ERG-negative (n=106) disease. Results: Free testosterone was significantly associated with the risk of ERG-positive prostate cancer (OR: 1.37, 95% CI: 1.05–1.77), but not ERG-negative prostate cancer (OR: 1.09, 95% CI: 0.86–1.38) (Pdiff=0.17). None of the remaining hormones evaluated showed clear differential associations with ERG-positive vs ERG-negative disease. Conclusions: These findings provide some suggestive evidence that higher pre-diagnostic free testosterone levels are associated with an increased risk of developing TMPRSS2:ERG-positive prostate cancer.en-UScirculating sex hormonesprostate cancerERG expressionJournal Article2017-05-0110.1038/bjc.2016.61