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Prostate Cancer Prevention

Summaries of the latest research concerning prostate cancer prevention By Hans R. Larsen MSc ChE and William R. Ware PhD FINASTERIDE (PROSCAR) AND PREVENTION OF PROSTATE CANCER The American Society of Clinical Oncology and the American Urological Association (ASCO and AUA) have issued a new guideline on the use of 5-alpha reductase inhibitors (5-ARI) for cancer chemoprevention. They found 15 randomized clinical trials that met their inclusion criteria. The main conclusion was that 5-ARI therapy during a 7-year period reduces the relative risk of developing prostate cancer by 25%. The absolute risk reduction however was only 1.4% which leads to about 71 persons needed to treat to prevent one cancer. Another way of looking at this result is that if 1000 men were followed over a period of 7 years, 59 would be expected to develop prostate cancer, and if they all took the 5-ARI, 45 would still develop cancer. This risk reduction is consistent with the result from the Prostate Cancer Prevention Trial which started in 1993 and was stopped in 2004 because of this same risk reduction. However, enthusiasm that should have arisen from this trial result, based on the 25% figure, was dramatically dampened by the suggestion that finasteride increased the risk of high-grade cancer. A majority (8 of 10) of members of the ASCO-AUA panel judged this higher observed incidence of high-grade cancer in the finasteride group to be due to confounding and thus not real. Finasteride is prescribed to relieve the symptoms of benign prostate hyperplasia (BPH

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