You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History (I)1 Apr 2013228 THE ASSOCIATION BETWEEN FINASTERIDE USE AND HIGH-GRADE OR LETHAL PROSTATE CANCER Mark A. Preston, Katherine Wilson, Sarah Coseo-Markt, Rongbin Ge, Edward Giovannucci, Christopher Morash, Meir Stampfer, Massimo Loda, Lorelei A. Mucci, and Aria F. Olumi Mark A. PrestonMark A. Preston Boston, MA More articles by this author , Katherine WilsonKatherine Wilson Boston, MA More articles by this author , Sarah Coseo-MarktSarah Coseo-Markt Boston, MA More articles by this author , Rongbin GeRongbin Ge Boston, MA More articles by this author , Edward GiovannucciEdward Giovannucci Boston, MA More articles by this author , Christopher MorashChristopher Morash Ottawa, Canada More articles by this author , Meir StampferMeir Stampfer Boston, MA More articles by this author , Massimo LodaMassimo Loda Boston, MA More articles by this author , Lorelei A. MucciLorelei A. Mucci Boston, MA More articles by this author , and Aria F. OlumiAria F. Olumi Boston, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1608AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite the widespread use of 5-alpha reductase inhibitors (5-ARIs) for benign prostatic hyperplasia (BPH), there is much controversy regarding the potential risk of high-grade prostate cancer when 5-ARIs are used for prostate cancer chemoprevention. Our objective was to determine the association between finasteride use, including duration of use, and the development of total, high-grade or lethal prostate cancer. METHODS The Health Professionals Follow-up Study is a prospective cohort of United States male health professionals who were 40 to 75 years old at baseline in 1986. Finasteride use was assessed on questionnaires every two years from 1996, and 38,430 men who were cancer-free in 1996 were followed for prostate cancer diagnosis until 2010. Cox proportional-hazard models were used to estimate risk associated with finasteride use, adjusting for possible confounders including age, time period, recent smoking history, race, family history of prostate cancer, vigorous physical activity, BMI, height, history of diabetes mellitus, history and intensity of PSA testing, history of physical examinations, history of prostate biopsy or rectal ultrasound, statins, digoxin, alpha-blockers, saw palmetto use, and vasectomy. RESULTS During 452,576 person-years of follow-up, we ascertained 3710 prostate cancer cases, 578 of which were advanced and 463 of which were high-grade. Of 38,419 men at baseline in 1996, 2920 (7.6%) reported use of Finasteride between 1986-2010. The age-adjusted relative risk for ever-use of Finasteride compared with never-use was 1.04 (95% CI=0.89-1.22) for total disease. After adjusting for confounders, ever use of Finasteride was associated with significantly lower risk of total disease, Gleason 7 and low-grade disease. The multivariable-adjusted relative risk was 0.77 (95% CI=0.65-0.90) for total disease, 0.66 (95% CI=0.49-0.89) for Gleason 7 disease, and 0.73 (95% CI=0.57-0.94) for low-grade disease. Finasteride use was not associated with risk of high-grade (RR=1.00, 95% CI=0.67-1.49) or lethal disease (RR=0.95, 95% CI=0.56-1.63). CONCLUSIONS Finasteride use was associated with a decreased risk of overall, low-grade, and Gleason 7 prostate cancer. Finasteride use, however, was not associated with either lowering or increasing the risk of high grade, or lethal prostate cancer as may have been suggested by previously published studies. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e94 Peer Review Report Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mark A. Preston Boston, MA More articles by this author Katherine Wilson Boston, MA More articles by this author Sarah Coseo-Markt Boston, MA More articles by this author Rongbin Ge Boston, MA More articles by this author Edward Giovannucci Boston, MA More articles by this author Christopher Morash Ottawa, Canada More articles by this author Meir Stampfer Boston, MA More articles by this author Massimo Loda Boston, MA More articles by this author Lorelei A. Mucci Boston, MA More articles by this author Aria F. Olumi Boston, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...