PD24-02 ASSOCIATIONS OF 5α-REDUCTASE INHIBITORS WITH DELAYED PROSTATE CANCER DIAGNOSIS AND INCREASED PROSTATE CANCER MORTALITY

Abstract

INTRODUCTION AND OBJECTIVES:5α-Reductase inhibitors (5-ARIs), commonly used to treat benign prostatic hyperplasia, reduce serum prostate-specific antigen (PSA) concentrations by 50%. The effect of 5-ARIs on prostate cancer detection in a PSA-screened population remains unclear. We tested the hypothesis that pre-diagnostic 5-ARI use is associated with a delayed diagnosis, more advanced disease, and higher risk of prostate cancer-specific mortality and all-cause mortality.METHODS:We linked the Veterans Affairs Informatics and Computing Infrastructure with the National Death Index to obtain patient records. The cohort included 80,875 men with American Joint Committee on Cancer stage I-IV prostate cancer diagnosed from 2001-2015. The exposure was pre-diagnostic 5-ARI use. The main outcomes were time from initial PSA elevation (defined as PSA ≥ 4 ng/mL) to diagnostic prostate biopsy, cancer grade and stage at time of diagnosis, and prostate cancer-specific and all-cause mortality. PSA was adjusted by doubling ...