{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:02:31Z","timestamp":1790870551721,"version":"4.1.0"},"reference-count":43,"publisher":"American Medical Association (AMA)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"abstract":"\n Importance<\/jats:title>\n Laryngeal and hypopharyngeal squamous cell carcinoma most commonly occur in men. It has been hypothesized that testosterone explains this sex difference, but there is a lack of research on the topic. 5\u03b1-Reductase inhibitors (5-ARIs) are common medications used for men with benign hyperplasia that inhibit the conversion of testosterone to the bioactive form dihydrotestosterone and, thus, have anti-androgenic properties.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine whether use of 5-ARIs is associated with lower risk of laryngeal and hypopharyngeal squamous cell carcinoma in men.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This population-based cohort study included men in the Swedish Prescribed Drugs and Health Cohort from July 1, 2005, to December 31, 2022, with follow-up until December 31, 2023.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n At least 2 dispensations of 5-ARIs within 2 years during the study period. Users of 5-ARIs were compared with 5 times as many age- and date-matched men without history of 5-ARI use.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n The main outcome was a new diagnosis of laryngeal or hypopharyngeal squamous cell carcinoma during follow-up. Multivariable Cox regression provided hazard ratios with 95% CIs, adjusted for alcohol overconsumption, tobacco smoking, hypertension, hyperlipidemia, and diabetes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 253\u202f010 users of 5-ARIs and 1\u202f265\u202f050 nonusers were included (median [IQR] age, 74 [67-80] years). The median (IQR) follow-up time was 5.8 (2.7-10.1) years among the 5-ARI users and 4.7 (1.0-9.4) years among the nonusers. Laryngeal or hypopharyngeal squamous cell carcinoma was diagnosed in 215 (0.1%) of the 5-ARI users and 1131 (0.1%) of the nonusers. Use of 5-ARIs was associated with a 17% lower risk of laryngeal or hypopharyngeal squamous cell carcinoma compared to nonusers (adjusted hazard ratio, 0.83; 95% CI, 0.72-0.96).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study, use of 5-ARIs was associated with a decreased relative risk of hypopharyngeal and laryngeal squamous cell carcinoma. This supports a possible partial role of testosterone in the origin and male predominance of these tumors.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoto.2026.3016","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:36:38Z","timestamp":1790868998000},"source":"Crossref","is-referenced-by-count":0,"title":["Testosterone Inhibition and Risk of Laryngeal and Hypopharyngeal Squamous Cell Carcinoma in Men"],"prefix":"10.1001","author":[{"given":"Eivind","family":"Gottlieb-Vedi","sequence":"first","affiliation":[{"name":"Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giola","family":"Santoni","sequence":"additional","affiliation":[{"name":"Upper Gastrointestinal Surgery, Department of 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