Is anogenital distance associated with prostate cancer risk

Abstract

Background. Anogenital distance (AGD) is shorter in females than males and in animal studies AGD has been related to fetal androgens. In children, endocrine disruptors were associated with AGD and in young adults, short distances were associated with low sperm concentration. Fetal exposures may affect the development of prostate cancer. We investigated the relationship between AGD and prostate cancer risk in an international study.Methods. 144 confirmed prostate cancer cases and 121 urological controls with determined low PSA levels were recruited in 3 hospitals in Spain and Germany. AGD from anus to scrotum (AGD-AS) and from anus to upper penis (AGD-AP) were measured and a questionnaire on socio-demographic and lifestyle information was administered. Odds ratios and 95% CI were adjusted for hospital, age and BMI.Results. AGD-AS was 3mm shorter in cases than controls. Decreased ORs were observed for each 5mm increase in AGD-AS, OR=0.94 (0.86-1.02). The OR for the third vs first tertile was 0.66 (0.35-1.25). There were no differences by Gleason (prognosis) score. The association was strongest in obese men (OR=0.86, 0.73-1.02) but the interaction with BMI was not significant (p-value=0.27). There was no association between AGD-AP and prostate cancer risk (OR=0.99, 0.90-1.09). A meta-analysis including the only published study, results in decreased ORs for both AGD-AS (OR=0.94; 0.87-1.02) and AGD-AP (OR=0.94; 0.86-1.03). Conclusions. A longer anogenital distance measured from anus to scrotum that may reflect normal in utero sexual development in men, may be associated with lower prostate cancer risk but results were not entirely consistent.