AccScience Publishing / GPD / Volume 2 / Issue 3 / DOI: 10.36922/gpd.1082
Cite this article
Journal Browser
Volume | Year
News and Announcements
View All

Testosterone as a biomarker of colorectal cancer in the South Indian population

Mohd Younis1,2,3* Sevgi Gezici4 Amrit Sudershan2 Sanjeev Kumar Digra5 Ashma Gupta6 Arun Meyyazhagan7 Parvinder Kumar2,3* Vijaya Anand1*
Show Less
1 Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore, Tamil Nadu, India
2 Institute of Human Genetics, University of Jammu, Jammu, Jammu and Kashmir, India
3 Department of Zoology, University of Jammu, Jammu, Jammu and Kashmir, India
4 Department of Medical Biology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
5 Department of Pediatrics, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India
6 Department of Zoology, Government College for Women, Gandhi Nagar, Jammu, Jammu and Kashmir, India
7 Department of Translation Medicine and Surgery, University of Perugia, Perugia, Italy
Submitted: 14 June 2023 | Accepted: 19 September 2023 | Published: 29 September 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( )

Colorectal cancer (CRC) is a highly life-threatening disease associated with a significant mortality rate. It has been proposed that testosterone levels may play a role in predisposing individuals to such devastating conditions. Testosterone primarily governs the maturation of the male reproductive system while also exerting physiological effects in both genders. In the present study, we investigated testosterone levels in CRC patients among the South Indian population. Blood samples were collected in the hospitals in Tamil Nadu, South India, and a cohort of healthy controls was selected for comparative analysis. A total of 130 subjects participated in the study, consisting of 65 CRC patients and an equal number of healthy controls. Approximately 7 mL of blood was collected from each subject for radioimmunoassay. The results of radioimmunoassay on the blood samples were analyzed using SPSS to assess differences between discrete and continuous data variables. Chi-square and t-tests were conducted for statistical evaluation. CRC patients exhibited significantly (P < 0.0001) reduced mean testosterone levels (06.68 ± 2.15 nmol/L) compared to controls (22.54 ± 8.85 nmol/L). Further stratification by smoking status revealed that non-smoker CRC patients had lower testosterone levels (06.81 ± 2.21 nmol/L) than non-smoking controls (10.15 ± 2.48 nmol/L), with a statistically significant difference (P < 0.0001). Adjusting for alcohol consumption, CRC patients displayed decreased mean testosterone levels (06.31 ± 2.30 nmol/L) compared to controls (07.96 ± 2.45 nmol/L), and this difference was found to be significant (P < 0.022). These findings support the notion that reduced testosterone levels serve as a critical risk biomarker in the pathogenesis of CRC.

Colorectal cancer
DST-PURSE-II, Bharathiar University, Government of India
  1. Siegel RL, Miller KD, Wagle NS, et al., 2023, Cancer statistics, 2023. CA Cancer J Clin, 73(1): 17–48.


  1. Xi Y, Xu P, 2021, Global colorectal cancer burden in 2020 and projections to 2040. Transl Oncol, 14(10): 101174.


  1. Mohd Y, Kumar P, Bhotla KH, et al., 2021, Transmission jeopardy of Adenomatosis polyposis coli and methylenetetrahydrofolate reductase in colorectal cancer. J Renin Angiotensin Aldosterone Syst, 2021: 7010706.


  1. Bracci M, Zingaretti L, Martelli M, et al., 2023, Alterations in pregnenolone and testosterone levels in male shift workers. Int J Environ Res Public Health, 20(4): 3195–4011.


  1. Roshan MH, Tambo A, Pace NP, 2016, The role of testosterone in colorectal carcinoma: Pathomechanisms and open questions. EPMA J, 7(1): 22.


  1. Murphy N, Strickler HD, Stanczyk FZ, et al., 2015, A prospective evaluation of endogenous sex hormone levels and colorectal cancer risk in postmenopausal women. J Natl Cancer Inst, 107: 210–227.


  1. Vesper HW, Botelho JC, 2010, Standardization of testosterone measurements in humans. J Steroid Biochem Mol Biol, 121(3–5): 513–519.


  1. Steinberger E, Ayala C, His B, et al., 1998, Utilization of commercial laboratory results in management of hyperandrogenism in women. Endocr Pract, 4(1): 1–10.


  1. Rosner W, Auchus RJ, Azziz R, et al., 2007, Position statement: Utility, limitations, and pitfalls in measuring testosterone: An endocrine society position statement. J Clin Endocrinol Metab, 92(2): 405–413.


  1. Bhasin S, Zhang A, Coviell A, et al., 2008, The impact of assay quality and reference ranges on clinical decision making in the diagnosis of androgen disorders. Steroids, 73(13): 1311–1317.


  1. Ahmad R, Singh JK, Wunnava A, et al., 2021, Emerging trends in colorectal cancer: Dysregulated signaling pathways (Review). Int J Mol Med, 47(3): 14.


  1. Murphy N, Xu L, Zervoudakis A, et al., 2017, Reproductive and menstrual factors and colorectal cancer incidence in the women’s health initiative observational study. Br J Cancer, 116(1): 117–125.


  1. Lin JH, Zhang SM, Rexrode KM, et al., 2013, Association between sex hormones and colorectal cancer risk in men and women. Clin Gastroenterol Hepatol, 11(4): 419–424.e1.


  1. Shiels MS, Rohrmann S, Menke A, et al., 2009, Association of cigarette smoking, alcohol consumption, and physical activity with sex steroid hormone levels in US men. Cancer Causes Control, 20: 877–886.


  1. Sainz A, Rudolph R, Hein M, et al., 2011, Association of genetic polymorphisms in ESR2, HSD17B1, ABCB1, and SHBG genes with colorectal cancer risk. Endocr Relat Cancer, 18(2): 265–276.


  1. Brenner H, Chen C, 2018, The colorectal cancer epidemic: Challenges and opportunities for primary, secondary and tertiary prevention. Br J Cancer, 119: 785–792.


  1. Younis M, Sujeetha P, Sangeetha T, et al., 2021, Molecular heterogeneity in colorectal cancer: Insights from genetic profiling. J Adv Appl Sci Res, 3(5): 6–15.


  1. Dimou N, Mori N, Harlid S, et al., 2021, Circulating levels of testosterone, sex hormone binding globulin and colorectal cancer risk: Observational and Mendelian randomization analyses. Cancer Epidemiol Biomarkers Prev, 30(7): 1336–1348.


  1. Mori N, Sawada N, Iwasaki M, et al., 2019, Circulating sex hormone levels and colorectal cancer risk in Japanese postmenopausal women: The JPHC nested case-control study. Int J Cancer, 145: 1238–1244.


  1. Yeap BB, Almeida OP, Hyde Z, et al., 2007, In men older than 70 years, total testosterone remains stable while free testosterone declines with age. The health in men study. Eur J Endocrinol, 156(5): 585–594.


  1. Orsted DD, Nordestgaard BG, Bojesen SE, 2014, Plasma testosterone in the general population, cancer prognosis and cancer risk: A prospective cohort study. Ann Oncol, 25(3): 712–718.


  1. Krasanakis T, Nikolouzakis TK, Sgantzos M, et al., 2019, Role of anabolic agents in colorectal carcinogenesis: Myths and realities (Review). Oncol Rep, 42(6): 2228–2244.


  1. Ben-Batalla I, Vargas-Delgado ME, Von Amsberg G, et al., 2020, Influence of androgens on immunity to self and foreign: Effects on immunity and cancer. Front Immunol, 11: 1184.


  1. Yang W, Giovannucci EL, Hankinson SE, et al., 2020, Endogenous sex hormones and colorectal cancer survival among men and women. Int J Cancer, 147(4): 920–930.


  1. Khaw KT, Dowsett M, Folkerd E, et al., 2007, Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men: European prospective investigation into cancer in Norfolk (EPIC-Norfolk) prospective population study. Circulation, 116: 2694–2701.


  1. Younis M, Arun M, Iqbal J, et al., 2018, Analysis of genetic alterations in colorectal cancer (CRC) patients in South Indian population. Int J Hum Genet, 18(3): 210–218.


  1. Harman SM, Metter EJ, Tobin JD, et al., 2001, Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore longitudinal study of aging. J Clin Endocrinol Metab, 86: 724–731.


  1. Chen CC, Yang SH, Lin JK, et al., 2005, Is it reasonable to add preoperative serum level of CEA and CA19-9 to staging for colorectal cancer? J Surg Res, 124(2): 169–174.


  1. Weissenberger C, Von Plehn G, Otto F, et al., 2005, Adjuvant radiochemotherapy of stage II and III rectal adenocarcinoma: Role of CEA and CA 19-9. Anticancer Res, 25(3A): 1787–1793.


  1. Mohd Y, Balasubramanian B, Meyyazhagan A, et al., 2021, Extricating the association between the prognostic factors of colorectal cancer. J Gastrointest Cancer, 52: 1022–1028.


  1. Alberg AJ, Gordon GB, Hoffman SC, et al., 2000, Serum dehydroepiandrosterone and dehydroepiandrosterone sulfate and the subsequent risk of developing colon cancer. Cancer Epidemiol Biomarkers Prev, 9(5): 517–521.


  1. Hundt S, Haug U, Brenner H, 2007, Blood markers for early detection of colorectal cancer: A systematic review. Cancer Epidemiol Biomarkers Prev, 16(10): 1935–1953.


  1. Locker GY, Hamilton S, Harris J, et al., 2006, ASCO 2006 update of recommendations for the use of tumor markers in gastrointestinal cancer. J Clin Oncol, 24(33): 5313–5327.


  1. Hyde Z, Flicker L, McCaul KA, et al., 2012, Associations between testosterone levels and incident prostate, lung, and colorectal cancer. A population-based study. Cancer Epidemiol Biomarkers Prev, 21(8): 1319–1329.


  1. Chakraborty S, Pramanik J, Mahata B, 2021, Revisiting steroidogenesis and its role in immune regulation with the advanced tools and technologies. Genes Immun, 22(3): 125–140.


  1. Lee HK, Lee JK, Cho B, 2013, The role of androgen in the adipose tissue of males. World J Mens Health, 31(2): 136–140.


  1. Chen E, Xu X, Liu T, 2018, Hereditary nonpolyposis colorectal cancer and cancer syndromes: Recent basic and clinical discoveries. J Oncol, 2018: 3979135.


  1. Li H, Pham T, McWhinney BC, et al., 2016, Sex hormone binding globulin modifies testosterone action and metabolism in prostate cancer cells. Int J Endocrinol, 2016: 6437585.


  1. Roshni K, Younis M, Ilakkiyapavai D, et al., 2018, Anticancer activity of biosynthesized silver nanoparticles using Murraya koenigii leaf extract against HT-29 colon cancer cell line. J Cancer Sci Ther, 10(4): 72–75.


  1. Saddozai UA, Wang F, Akbar MU, et al., 2021, Identification of clinical relevant molecular subtypes of pheochromocytoma. Front Endocrinol (Lausanne), 12: 605797.


  1. Saddozai UA, Wang F, Cheng Y, et al., 2020, Gene expression profile identifies distinct molecular subtypes and potential therapeutic genes in Merkel cell carcinoma. Transl Oncol, 13(11): 100816.


  1. Akbar MU, Badar M, Zaheer M, 2022, Programmable drug release from a dual-stimuli responsive magnetic metal organic framework. ACS Omega, 7(36): 32588–32598.


  1. Sawicki T, Ruszkowska M, Danielewicz A, et al., 2021, A review of colorectal cancer in terms of epidemiology, risk factors, development, symptoms and diagnosis. Cancers (Basel), 13(9): 2025.


  1. Saddozai UA, Wang F, Khattak S, et al., 2022, Define the two molecular subtypes of epithelioid malignant pleural mesothelioma. Cells, 11(18): 2924.


  1. Baraibar I, Ros J, Saoudi N, et al., 2023, Sex and gender perspectives in colorectal cancer. ESMO Open, 8(2): 101204.
Conflict of interest
The authors affirm that they do not have any competing interests.
Back to top
Gene & Protein in Disease, Electronic ISSN: 2811-003X Published by AccScience Publishing