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Home All Specialties Oncology

Use of 5α-reductase inhibitors may not increase risk of high-grade prostate cancer

byDavid WangandAndrew Bishara
June 7, 2014
in Oncology, Urology
Reading Time: 3 mins read
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Image: PD

1. The use of 5α-reductase inhibitors (5ARIs) was not associated with increased risk of developing high-grade or lethal prostate cancer.

2. 5ARI use was associated with a decreased incidence of low-risk and overall prostate cancer.

Evidence Rating Level: 2 (Good)

Study Rundown: 5ARIs have previously been associated with a decreased incidence of prostate cancer in large randomized control trials; however, the same trials also demonstrated an increased risk of high-grade prostate cancer. The authors of this paper prospectively followed 38,058 men from 1996 to 2010 to further elucidate the relationship between 5ARI use and the incidence of high-grade prostate cancer. This study demonstrated that 5ARI use was not associated with an increased risk of high-grade (HR: 0.97; 95% CI:0.64-1.46) or lethal (HR: 0.99; 95% CI: 0.58-1.69) prostate cancer. Furthermore, no associations were found between duration of 5ARI use and the incidence of high-grade prostate cancer. This study also supports the results of previous randomized controlled trials that demonstrated that 5ARI use was associated with a significant decrease in the overall incidence of prostate cancer (HR: 0.77; 95%CI: 0.57-0.95). The strength of this study is the prospective design along with the long follow-up period, but all participants in this study were Caucasian males, which limit the generalizability of this result.

Click to read the study in JAMA Internal Medicine

Relevant Reading: Long-term survival of participants in the prostate cancer prevention trial

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In-Depth [prospective study]: This prospective observational study followed 38,058 men from 1996 to 2010 as part of the Health Professionals Follow-up Study in Boston, Massachusetts. In 448,803 person-years of follow-up, there were 289 cases of lethal and 456 cases of high-grade (Gleeson score 8-10) prostate cancer. Use of 5ARIs was reported by 2878 (7.6%) participants. Cox proportional hazard models demonstrated no significant association between use of 5ARIs and high-grade or lethal prostate cancer (HR: 0.99; 95% CI: 0.58-1.69). No associations were detected when the definition of high-grade cancer were expanded to include Gleeson score 7 (HR: 1.07; 95% CI: 0.79-1.45). Increased duration of 5ARI use was significantly associated with a decrease in overall prostate cancer (HR for 1 additional year of use: 0.95; 95% CI: 0.92-0.99); however no association was found between duration of use and high-grade prostate cancer.

More from this author: Asymptomatic H. pylori eradication decreased gastric cancer in Asian populations, Gender differences in white matter integrity may affect post-traumatic brain injury, Pulse oximetry screening improved detection of congenital heart disease in China, Stool DNA testing may improve screening sensitivity of colorectal cancer,Radical prostatectomy may trump radiotherapy in non-metastatic prostate cancer

©2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. 

Tags: 5 alpha reductase inhibitorsoncologyprostate cancerrisk of cancerUrology
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