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ASCO-GU: Prostate Cancer Prevention Talk Advised

Healthy men urged to talk to their doctors about taking a 5-alpha reductase inhibitor

THURSDAY, Feb. 26 (HealthDay News) -- Healthy men should talk to their doctors about taking a 5-alpha reductase inhibitor (5-ARI) to reduce their risk of prostate cancer, according to a joint guideline published online Feb. 24 in the Journal of Clinical Oncology by the American Society of Clinical Oncology and the American Urological Association, and released to coincide with the American Society of Clinical Oncology's Genitourinary Cancers Symposium held Feb. 26 to 28 in Orlando. The guidelines will also appear in the March issue of the Journal of Urology.

Barnett S. Kramer, M.D., of the National Institutes of Health in Bethesda, Md., and colleagues identified 15 randomized clinical trials that met the inclusion criteria. Among the nine trials that reported prostate cancer period-prevalence was the Prostate Cancer Prevention Trial, which showed an overall risk reduction of about 25 percent in men who took finasteride for one to seven years but also an increased risk of developing high-grade prostate cancer compared to men who took placebo.

A key recommendation in the guideline states that men with a prostate-specific antigen score of less than or equal to 3.0 ng/mL and no signs of prostate cancer, who receive regular screening, should talk with their doctor about the risks (including the risk of high-grade prostate cancer) and benefits of using 5-ARIs as a chemopreventative agent. The guideline also recommends this dialogue for men who are receiving 5-ARIs as treatment for another condition.

"Although a large clinical trial has shown that 5-ARIs can decrease the incidence of prostate cancer, we are still not able to determine if the mortality from prostate cancer is reduced," Paul F. Schellhammer, M.D., co-chair of the panel that developed the guideline, explained in a statement. "However, the demonstrated effect of 5-ARIs in reducing prostate cancer incidence makes it reasonable to recommend them for use to prevent the disease."

Two authors disclosed consultant or advisory roles with GlaxoSmithKline, and one author disclosed a relationship with Merck.

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