Use of 5α-reductase inhibitors for benign prostate hypertrophy and risk of high-grade prostate cancer: A French population-based study.
BJU Int. 2018 Jul 19;:
Authors: Scailteux LM, Rioux-Leclercq N, Vincendeau S, Balusson F, Nowak E, Oger E
BACKGROUND: To assess the association between 5α-reductase inhibitor (5-ARI) use and high grade (Gleason score 8-10) prostate cancer.
METHODS: We set up a population-based nested matched case-control study using the French Health Insurance Database linked to data from all Brittany (France) path labs. Among 74,596 men with ≥ 1 drug reimbursement for symptomatic benign prostate hypertrophy between January 1, 2010 through December 31, 2011, 767 incident prostate cancer cases between January 1, 2012 through December 31, 2013 were matched on age and delay between the first observed delivery of drug for benign prostate hypertrophy (5-ARI, alpha-blockers or phytotherapy) and diagnostic date of the case to five controls, using an incidence density sampling design.
RESULTS: 963 men (153 cases, 810 controls) had been exposed to 5-alpha reductase inhibitors. A statistically significant heterogeneity (p = 0.0048) was detected across cancer grades when estimating association between prostate cancer and 5-alpha reductase inhibitors long term use (≥ 2 years) versus no 5-alpha reductase inhibitor exposure: adjusted conditional odds ratio was 1.76 [0.97-3.21] for Gleason ≥ 8, and 0.64 [0.44-0.93] for Gleason < 8.
INTERPRETATION: Our results supported an increased risk for high-grade and a decreased risk for low-grade prostate cancer. Patients treated for longer than 2 years with 5-alpha reductase inhibitors should be informed of increased risk for the development of high-grade disease. This article is protected by copyright. All rights reserved.
PMID: 30025199 [PubMed - as supplied by publisher]