Polymorphisms in genes regulating androgen activity among prostate cancer low-risk Inuit men and high-risk Scandinavians.

In Greenland, with a male population of approximately 30 000 individuals, the incidence of prostate cancer is extremely low with only three cases described during the period 1988-1997. Polymorphisms related to high androgen metabolism and/or response in the 5alpha-reductase type 2 (SRD5A2) and the androgen receptor (AR) genes, respectively, have been linked to prostate cancer. Our objective was to analyse whether the distribution of these polymorphisms differed between the prostate cancer low-risk population from Greenland and the relatively high-risk Swedish male population. The SRD5A2 polymorphisms A49T, V89L and R227Q, and the CAG and GGN repeats in the AR gene were genotyped in leucocyte DNA from 196 Greenlanders and 305 Swedish military conscripts. All subjects had the wild-type R/R genotype of the R227Q marker. The high-activity variants A49T A/T and V89L V/V occurred less frequently (2% vs. 5%, p = 0.048 and 33% vs. 46%, p = 0.0027) in Greenland compared with Sweden, whereas the low-activity L/L genotype was more frequent in Greenland (24% vs. 13%, p = 0.0024). Greenlanders also had longer AR CAG repeats than the Swedish population (median 24 vs 22, p < 0.0005). Greenlanders also had a higher frequency of the GGN = 23 allele (85% vs. 54%, p < 0.0001). Our results suggest that Greenlanders are genetically predisposed to a lower activity in testosterone to 5alpha-dihydrotestosterone turnover and to lower AR activity, which, at least partly, could explain their low incidence of prostate cancer.