The role of steroid hormones in the etiology of urologic diseases

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One of the main goals of my doctoral training has been to gain experience working with a variety of types of epidemiologic data. The three projects that compose this dissertation have provided me with the opportunity to work with several different data structures: (1) published summary data, (2) population-based family data, (3) prospective cohort data, and (4) population-based case-control data.; For my dissertation, I have employed each of these data structures to investigate the role of steroid hormones in the etiology of several urologic diseases. In the last several decades of epidemiologic research, it has become clear that steroid hormones are involved in many disease processes. For my research, I have studied the relationships between steroid hormone exposure and molecules of steroid hormone response and female bladder cancer, as well as two male urologic diseases: infertility and testicular germ cell tumors.; In my first paper, I investigated the association between male infertility and a polymorphic CAG repeat tract in the androgen receptor gene (AR) through the meta-analysis of a large body of existing literature on the topic. I quantitatively summarized 33 studies, and found that infertile male cases had statistically significantly longer mean CAG repeat length than controls (SMD: 0.19, 95% CI: 0.09-0.29). Meta-analysis of a select subset of 13 studies that used more stringent case and control selection criteria revealed a larger difference between cases and controls (SMD: 0.31, 95% CI: 0.14-0.47). This meta-analysis provides support for an association between increased androgen receptor CAG length and idiopathic male infertility, and brings together for the first time results from many published reports on this topic.; In my second paper, I expanded upon the results of the meta-analysis to conduct an original data analysis studying the association between androgen receptor CAG repeat length and risk of testicular germ cell tumors. Increasing rates of te