Greater Percent-free Testosterone Is Associated With High-grade Prostate Cancer in Men Undergoing Prostate Biopsy

Urology, 05/23/2012

In white Italian men, a greater percent–free testosterone (%FT) level was associated with an increased risk of high–grade prostate cancer (PCa) on initial prostate biopsy. These findings suggest that a high %FT level, rather than the absolute androgen levels, might be associated with high–grade PCa.


  • From 2006 to 2010, the authors collected data on 812 white Italian men with no history of PCa who underwent 12-core biopsy.
  • The testosterone, free testosterone, and %FT (free testosterone/total testosterone) were examined as predictors of low-grade (Gleason score of ≤6) and high-grade (Gleason score ≥7) PCa using crude and adjusted multinomial logistic regression analysis.


  • On multivariate analysis, testosterone (P ≥ .11) and free testosterone (P≥.45) were not significantly associated with low- or high-grade PCa.
  • A greater %FT level significantly predicted high-grade PCa on both crude (P=.01) and multivariate (P=.02) analysis but not low-grade PCa (P≥.38).
  • When examined in tertiles, men in the greatest %FT tertile had a significant twofold increased risk of high-grade PCa (odds ratio 2.04, 95% confidence interval 1.23-3.37, P=.005).

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