Tracing Change in Scientific Consensus: Testosterone, Race and Controversy in Prostate Cancer Research

• In Event: Technology and/in Racial Formations

Abstract

For more than seven decades, the theory that higher levels of testosterone contributed to prostate cancer risk was an unquestioned tenet of biomedical research, leading to the development of the multi-billion dollar androgen-deprivation therapy industry. In recent years, this relationship has become the focal point of controversy. Using Shwed and Bearman’s (2010) quantitative method to examine patterns of scientific consensus in citation networks from 1980-2017, I demonstrate that the association between testosterone and prostate cancer has undergone a radical paradigm shift over the past 25 years. While high levels of testosterone were once considered a robust predictor of prostate cancer risk, an emerging group of biomedical scholars now argue that clinically low levels of testosterone may, in fact, be a more accurate risk factor for this disease. Reading these findings through the literature on the pharmaceuticalization of race, I elaborate on how this paradigm shift affects the construction of prominent clinical guidelines for testosterone-based pharmaceuticals and the impact this has on black men. Although these guidelines have traditionally advised against prescribing testosterone to men with prostate cancer in addition to African American men, because of their increased risk of this disease, emerging evidence undermines these recommendations, leaving a constellation of controversies haunted by the legacy of scientific racism. More generally, my analysis shows that critical periods of pharma-funded drug development can induce the fragmentation of scientific fields, shaping the historical trajectory of scientific consensus along the way.

Author

• Brandon Kramer, University of Virginia