New Study Dispels Fears Related to Finasteride’s Prostate Cancer Risk

A previous study indicated that finasteride—a 5-alpha-reductase inhibitor commonly used for benign prostatic hyperplasia and male pattern baldness—increased the risk of high-grade prostate cancer. However, new, longer-term research published in The New England Journal of Medicine showed no increase in prostate cancer-related deaths with the use of finasteride. 

The landmark Prostate Cancer Prevention Trial began in the 1990s, with researchers randomizing more than 18,000 American men aged 55 years and older to receive finasteride 5 mg daily or placebo for 7 years. 

The original results, published in 2003, showed that the risk of prostate cancer was 24.8% lower with finasteride compared with placebo. However, the results also showed a significant increase in the number of high-grade cancers in patients receiving finasteride compared with placebo (280 vs. 237, respectively). 

In the latest analysis (median follow-up = 18.6 years), however, there were fewer prostate cancer deaths in the finasteride group than the placebo group (42 vs. 56, respectively), translating to a 25% lower risk of death from prostate cancer with finasteride (hazard ratio = 0.75; 95% CI, 0.50-1.12). 

Some prostate cancer patients may gain 3 years of life with radical prostatectomy. 

Higher survival rates in seen in prostate cancer patients who are treated with surgery and radiation than radiation and hormone therapy. 

SourceThe New England Journal of Medicine