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Background: We examined associations between two forms of testosterone therapy (TT) and risks of seven cancers among men. Methods: SEER-Medicare combines cancer registry data from the Surveillance, Epidemiology, and End Results programme with Medicare claims. Our population-based case–control study included incident cancer cases diagnosed between 1992–2015: prostate (n = 130,713), lung (n = 105,466), colorectal (n = 56,433), bladder (n = 38,873), non-Hodgkin lymphoma (n = 17,854), melanoma (n = 14,241), and oesophageal (n = 9116). We selected 100,000 controls from a 5% random sample of Medicare beneficiaries and used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI). Results: TT was associated with lower risk of distant-stage prostate cancer (injection/implantation OR = 0.72, 95% CI: 0.60–0.86; topical OR = 0.50, 95% CI: 0.24–1.03). We also observed inverse associations for distant-stage colorectal cancer (injection/implantation OR = 0.75, 95% CI: 0.62–0.90; topical OR = 0.11, 95% CI: 0.05–0.24). Risks of distant-stage colorectal and prostate cancers decreased with time after initiating TT by injection/implantation. By contrast, TT was positively associated with distant-stage melanoma (injection/implantation OR = 1.70, 95% CI: 1.37–2.11). TT was not associated with bladder cancer, oesophageal cancer, lung cancer or non-Hodgkin lymphoma. Conclusion: TT was inversely associated with distant-stage prostate and colorectal cancers but was positively associated with distant-stage melanoma. These observations may suggest an aetiologic role for TT or the presence of residual confounding.

Introduction: The ageing population represents significant nutritional challenges; where vulnerabilities to obesity, malnutrition and age-related diseases are exacerbated by impaired dental and oral health status. As natural teeth are lost, many older adults choose softer, more manageable foods lacking in essential micronutrients and fibre, yet replacing missing natural teeth alone does not positively influence diet. This systematic review synthesised literature relating to oral rehabilitation coupled with dietary intervention in adults. The primary outcome was diet/nutritional status; secondary outcomes pertained to health status (e.g. body mass index (BMI)), oral health and dietary intervention characteristics including: theoretical basis, intervention delivery and behaviour change techniques (BCTs). Methods: MEDLINE, Web of Science, PubMed and CENTRAL were searched systemically, alongside hand-searching reference lists and contacting authors. Studies were eligible if they replaced missing teeth in edentate/partially dentate adults and included a dietary intervention, reporting diet/nutritional outcomes. Results: Nine studies were included. Study designs were heterogeneous (three RCTs; five single-arm; one parallel-groups) involving 526 participants. Narrative synthesis identified improvements in all studies for least one aspect of patients' oral health (i.e. chewing) alongside at least one positive diet/nutrition outcome post-intervention (including some plasma biomarkers). Dietary outcomes included increased fruit/vegetable (F/V), protein and fibre intake. F/V results were pooled for three studies using meta-analysis techniques resulting in a standardised mean difference (SMD) of 0.29 [CI -0.54, 1.12], p = 0.49, but with marked heterogeneity (p = 0.0007). Five of nine studies reported BMI at baseline (three reported average BMI values of 22.5-22.9 kg/m2; two reported average BMI values of 26.8-27.4 kg/m2). Despite positive dietary changes in four of these studies, BMI did not change significantly post-intervention (reported in two studies with overweight participants only). Few interventions were theory- based with intervention components and delivery poorly described. Identifiable BCTs ranged from one to nine; five interventions tailored dietary information, and the most common BCT was giving information on the health consequences of diet. Conclusion: Narrative synthesis indicated support for dietary intervention coupled with oral rehabilitation on improving intake. Impact on BMI from dietary intervention was unclear from the limited results reported. Meta-analysis of F/V intake was only possible with three studies, highlighting limitations. Further research with large-scale, appropriately designed and described trial methodologies is needed.