Public Health Challenge

The purpose of the Hormone Demonstration Program is to maximize the utility of the hormone data that is being generated from NHANES III to answer questions about men’s health, including prostate cancer and aging. We have patterned the Hormone Demonstration Program on the Prostate Cancer Demonstration Program. This Program is funded by the Maryland Cigarette Restitution Fund at Johns Hopkins. This is a highly collaborative process, with attendees of the Working Group meeting freely brainstorming about questions that are answerable using these hormone data. Nearly 30 junior and senior investigators have contributed.

Research Findings

As part of the Program, the investigators measured serum concentrations of testosterone, estradiol, and sex hormone binding globulin in adult participants in the National Health and Nutrition Examination Survey III. In a prospective analysis, men with low free testosterone and free estradiol had a higher risk of all cause mortality and cardiovascular mortality than men with higher levels. In addition, men with low free testosterone were more likely to die of cancer. These men may also be at risk for other adverse health concerns, including low bone mineral density. We estimated the proportion and the absolute number of men by decade of age with low total and free testosterone; more than 65% of men 70+ years old have low free testosterone, which equals about 6.8 million US men.

Possible Directions

Findings on the associations of hormones and measures of inflammation, leptin, vitamin D, selenium, the healthy eating index, fraility, as well as predictors of clinically low hormone concentration and racial variation in hormones in adolescence will be reported in future LunchLearnLink seminars. Many of these factors have relevance not just for healthy aging but avoidance of cancer. At this time there is no consensus on clinically relevant cut points for low testosterone and estradiol in adult men. Based on our data, we expect to be able to provide data to support the choice of a set of cut points.

Future Research Opportunities

The Hormone Demonstration Program is an ongoing collaboration. The group welcomes all investigators with interest in hormones and cancer and other aspects of men’s health.