Does finasteride prevent prostate cancer?

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Does finasteride prevent prostate cancer?
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Treatment with finasteride will, over 7 years, decrease the prevalence of prostate cancer but increase the likelihood of developing a high-grade cancer. For every 1000 men given finasteride for prostate cancer, 62 will not develop prostate cancer. In addition, 35 men will not develop benign prostatic hypertrophy, 27 will have less urinary urgency or frequency, and 21 will report less urinary retention.

However, of those that develop prostate cancer, 13 will have higher-grade cancer (Gleason score 7 or higher), 59 will have erec-tile dysfunction, 58 will have a loss of libido, and 131 will have reduced volume of ejaculate. This study provides no information on the clinical significance of reducing the overall rate of cancer, while increasing higher-grade tumors. Since it is unclear whether finasteride reduces morbidity or mortality, it cannot be recommended for the routine prevention of prostate cancer.

 
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Thompson IM, Goodman PJ, Tangen CM, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med 2003; 349:215–224.

Alphaeus M. Wise, MD
James J. Stevermer, MD, MSPH
Department of Family and Community Medicine, University of Missouri–Columbia. E-mail: wiseam@health.missouri.edu.

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The Journal of Family Practice - 52(11)
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Thompson IM, Goodman PJ, Tangen CM, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med 2003; 349:215–224.

Alphaeus M. Wise, MD
James J. Stevermer, MD, MSPH
Department of Family and Community Medicine, University of Missouri–Columbia. E-mail: wiseam@health.missouri.edu.

Author and Disclosure Information

Thompson IM, Goodman PJ, Tangen CM, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med 2003; 349:215–224.

Alphaeus M. Wise, MD
James J. Stevermer, MD, MSPH
Department of Family and Community Medicine, University of Missouri–Columbia. E-mail: wiseam@health.missouri.edu.

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PRACTICE RECOMMENDATIONS

Treatment with finasteride will, over 7 years, decrease the prevalence of prostate cancer but increase the likelihood of developing a high-grade cancer. For every 1000 men given finasteride for prostate cancer, 62 will not develop prostate cancer. In addition, 35 men will not develop benign prostatic hypertrophy, 27 will have less urinary urgency or frequency, and 21 will report less urinary retention.

However, of those that develop prostate cancer, 13 will have higher-grade cancer (Gleason score 7 or higher), 59 will have erec-tile dysfunction, 58 will have a loss of libido, and 131 will have reduced volume of ejaculate. This study provides no information on the clinical significance of reducing the overall rate of cancer, while increasing higher-grade tumors. Since it is unclear whether finasteride reduces morbidity or mortality, it cannot be recommended for the routine prevention of prostate cancer.

 
PRACTICE RECOMMENDATIONS

Treatment with finasteride will, over 7 years, decrease the prevalence of prostate cancer but increase the likelihood of developing a high-grade cancer. For every 1000 men given finasteride for prostate cancer, 62 will not develop prostate cancer. In addition, 35 men will not develop benign prostatic hypertrophy, 27 will have less urinary urgency or frequency, and 21 will report less urinary retention.

However, of those that develop prostate cancer, 13 will have higher-grade cancer (Gleason score 7 or higher), 59 will have erec-tile dysfunction, 58 will have a loss of libido, and 131 will have reduced volume of ejaculate. This study provides no information on the clinical significance of reducing the overall rate of cancer, while increasing higher-grade tumors. Since it is unclear whether finasteride reduces morbidity or mortality, it cannot be recommended for the routine prevention of prostate cancer.

 
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The Journal of Family Practice - 52(11)
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The Journal of Family Practice - 52(11)
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828-848
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828-848
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Does finasteride prevent prostate cancer?
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