Low Testosterone Tied to Higher Risk of Prostate Cancer Progression for Men in Active Surveillance

TUESDAY, March 17, 2026 (HealthDay News) -- Low testosterone levels may increase the risk of higher-grade “extreme” progression of prostate cancer among men enrolled in active surveillance (AS), according to a study published online Feb. 24 in The Journal of Urology.Tarek Lawen, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues evaluated the association between baseline serum testosterone levels and grade group progression in men undergoing AS for localized prostate cancer. Analysis included 924 men enrolled in an AS program (2001 to 2024), with a median follow-up of 46.1 months.The researchers found that the average baseline testosterone was 394 ng/dL, with 29.4 percent of men having a testosterone level ≤300 ng/dL. There was a significant association between low testosterone and increased risk of "extreme" progression to grade group 3 or higher (hazard ratio [HR], 1.61; 95 percent confidence interval [CI], 1.03 to 2.51; P = 0.04). However, low testosterone was not associated with risk of grade group 2 progression (HR, 1.23, 95 percent CI, 0.93 to 1.64; P = 0.15). Findings were similar when using alternative cut-points for testosterone and when considering other potential confounders."Active surveillance is a safe and effective option for many men with early-stage prostate cancer. However, identifying which patients may be more likely to experience progression remains a key challenge," coauthor Justin R. Gregg, M.D., also from MD Anderson, said in a statement. "Understanding how hormonal factors influence prostate cancer biology may help us refine surveillance strategies."Several authors disclosed ties to the biopharmaceutical industry.Abstract/Full Text (subscription or payment may be required).Sign up for our weekly HealthDay newsletter

Low Testosterone Tied to Higher Risk of Prostate Cancer Progression for Men in Active Surveillance

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