New study, so a separate post, but will interest those who followed the recent Finasteride thread. This is more of the same.
"A retrospective 20‐year cohort study in Saskatchewan men ..."
"5ARI use was associated with lower risk of a PC diagnosis, regardless of comparison group. Risk of high‐grade PC was higher among both 5ARI users and α‐blocker users compared with non‐users; however, this did not translate into higher risk of PC mortality."
Impact of 5α‐Reductase Inhibitors and α‐Blockers for Benign Prostatic Hyperplasia on Prostate Cancer Incidence and Mortality
Maria I. Van Rompay J. Curtis Nickel Gayatri Ranganathan Philip W. Kantoff Keith R. Solomon Jennifer L. Lund John B. McKinlay
First published: 14 September 2018
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/bju.14534
To investigate the use of 5α‐reductase inhibitors (5ARIs) and α‐blockers among men with benign prostatic hyperplasia (BPH) in relation to prostate cancer (PC) incidence, severity, and mortality.
Patients and Methods
A retrospective 20‐year cohort study in Saskatchewan men aged 40‐89 years with a BPH‐coded medical claim between 1995 and 2014 was conducted. Cox proportional hazards regression was used to compare incidence of a PC diagnosis, metastatic PC, Gleason score 8‐10 PC, and PC mortality among 5ARI users (n=4,571), α‐blocker users (n=7,764), and non‐users (n=11,677).
In comparison with both non‐users and α‐blocker users, 5ARI users had approximately 40% lower risk of a PC diagnosis (11.0% and 11.4% vs. 5.8%, respectively); α‐blocker users had 11% lower risk of a PC diagnosis compared with non‐users. Overall, there was no significant increase in metastatic PC or PC mortality among 5ARI or α‐blocker users (metastatic PC: 0.8% and 1.5% vs. 1.4% [non‐users]; PC mortality: 1.2% and 2.4% vs. 2.2% [non‐users], respectively, P>0.05 for both drugs) but there was approximately 30% higher risk of Gleason score 8‐10 cancer (1.4% and 1.8% vs. 2.0% [non‐users], aHR: 1.37, 95% CI: 1.03‐1.82, P=0.03 and aHR: 1.28, 95% CI: 1.03‐1.59, P=0.02, respectively) compared with non‐users.
5ARI use was associated with lower risk of a PC diagnosis, regardless of comparison group. Risk of high‐grade PC was higher among both 5ARI users and α‐blocker users compared with non‐users; however, this did not translate into higher risk of PC mortality.