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Letter to the Editor

Finasteride and High-Grade Prostate Cancer

Jonathan L. Edwards
Jonathan L. Edwards
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DOI: 10.1158/1940-6207.CAPR-08-0117 Published February 2009
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To the Editor: In the Prostate Cancer Prevention Trial, an increased rate of high-grade cancer was observed in the finasteride group (1). The recently published analysis by Redman et al. (2) suggests that this observation was the result of detection bias rather than a true increase. However, the marked increase in the estimated rate of high-grade cancer in the placebo group calls into question the validity of the model. If the true rate of high-grade cancer in the placebo group was indeed 8.2%, then ∼40% of all high-grade cancers were missed despite annual screening. Because untreated, high-grade prostate cancer is associated with a 45% rate of metastatic disease after 5 years (3), one may conservatively estimate that 100 cases of metastatic prostate cancer should have developed in the placebo group in the 5 years since publication of the Prostate Cancer Prevention Trial. Do the authors have follow-up data to confirm this expectation?

Disclosure of Potential Conflicts of Interest

No potential conflicts of interest were disclosed.

  • Received June 17, 2008.
  • Accepted December 9, 2008.
  • ©2009 American Association for Cancer Research.

References

  1. ↵
    1. Thompson IM,
    2. Goodman PJ,
    3. Tangen CM,
    4. et al
    . The influence of finasteride on the development of prostate cancer. N Engl J Med 2003;349:215–24.
    OpenUrlCrossRefPubMed
  2. ↵
    1. Redman MW,
    2. Tangen CM,
    3. Goodman PJ,
    4. Lucia MS,
    5. Coltman CA Jr..,
    6. Thompson IM
    . Finasteride does not increase the risk of high-grade prostate cancer: A bias-adjusted modeling approach. Cancer Prev Res2008;1:174–81.
    OpenUrlAbstract/FREE Full Text
  3. ↵
    1. Chodak GW,
    2. Thisted RA,
    3. Gerber GS,
    4. et al
    . Results of conservative management of clinically localized prostate cancer. N Engl J Med 1994;330:242–8.
    OpenUrlCrossRefPubMed
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Cancer Prevention Research: 2 (2)
February 2009
Volume 2, Issue 2
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Finasteride and High-Grade Prostate Cancer
Jonathan L. Edwards
Cancer Prev Res February 1 2009 (2) (2) 185; DOI: 10.1158/1940-6207.CAPR-08-0117

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Finasteride and High-Grade Prostate Cancer
Jonathan L. Edwards
Cancer Prev Res February 1 2009 (2) (2) 185; DOI: 10.1158/1940-6207.CAPR-08-0117
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Cancer Prevention Research
eISSN: 1940-6215
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