BMJ  2006;333:654 (23 September), doi:10.1136/bmj.333.7569.654-a

Letter

Benign prostatic hyperplasia

Authors' reply

EDITOR—A recent expert European consensus group (in which the senior author (CRC) was a key participant) reviewed the data from both the prostate cancer prevention trial and the medical therapy of prostatic symptoms study.^1-3 The consensus was that the studies provide additional support for the use of finasteride in managing men with lower urinary tract symptoms and benign prostatic hyperplasia and that the increased incidence of diagnosed high grade cancer in the finasteride treated group compared with placebo is probably a consequence of a relative detection bias in the finasteride group caused by a reduction in prostate volume.

Treatment with finasteride therefore enhances detection of high grade disease, in addition to reducing the overall seven year prevalence of prostate cancer by 24.8% compared with placebo (P < 0.001). The group concluded that discussing chemoprevention using finasteride with men concerned about prostate cancer (family history, abnormal prostate specific antigen (PSA) value) may be appropriate and that the consensus findings need to be disseminated to other healthcare professionals and guidelines on prostate cancer updated.

Urology Research, J Floor, Royal Hallamshire Hospital, Sheffield S10 2JF

c.r.chapple{at}sheffield.ac.uk Urology Research, J Floor, Royal Hallamshire Hospital, Sheffield S10 2JF

---

Competing interests: CRC has acted as a consultant or received research funding (or both) from Pfizer, Astellas, Abbott, and Recorati Pharmaceuticals. AKP has no competing interests to declare.

References

1. Teillac P, Abrahamsson PA. The prostate cancer prevention trial and its implications for clinical practice: A European consensus. European Urology Supplements 2006;suppl 5: 640-6.
2. Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med 2003;349: 215-24.[Abstract/Free Full Text]
3. McConnell JD, Roehrborn CG, Bautista OM, Andriole GL, Dixon CM, Kusek JW, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med 2003;349: 2387-98.[Abstract/Free Full Text]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?