Prostate cancer incidence among finasteride and alpha-blocker users in the Finnish Prostate Cancer Screening Trial

Abstract

Background:The Prostate Cancer Prevention Trial has shown a protective effect of finasteride on prostate cancer in low-risk men. It is uncertain whether similar results can be expected when finasteride is used to treat benign prostatic hyperplasia.Methods:We performed an observational cohort study within the Finnish Prostate Cancer Screening Trial. Using a comprehensive prescription database on medication reimbursements during 1995–2004 of men using finasteride or alpha-blockers for benign prostatic hyperplasia, we evaluated prostate cancer incidence among 23 320 men screened during 1996–2004.Results:Compared to medication non-users, overall prostate cancer incidence was not significantly affected in finasteride users (hazard ratio 0.87; 95% CI 0.63–1.19). Incidence of Gleason 2–6 tumours, however, was decreased among finasteride users (HR 0.59; 95% CI 0.38–0.91), whereas incidence of Gleason 7–10 tumours was unchanged (HR 1.33; 95% CI 0.77–2.30). The protective effect concerned mainly screen-detected tumours. Overall prostate cancer risk was not significantly reduced among alpha-blocker users relative to non-users, but decreased incidence of high-grade tumours was observed (0.55; 95% CI 0.31–0.96).Conclusions:The detection of low-grade, early-stage tumours is decreased among men who use finasteride for symptomatic BPH. The protective effect of finasteride can also be expected in men with benign prostatic hyperplasia.

Naftopidil, a Selective α1-Adrenoceptor Antagonist, Suppresses Human Prostate Tumor Growth by Altering Interactions between Tumor Cells and Stroma

“…Harris et al reported that the administration of quinazoline-based a 1 -AR antagonists (subtype nonselective: doxazosin or terazosin) significantly decreased the incidence of PCa (1). Murtola et al reported that the administration of a 1 -AR antagonists (subtype nonselective: alfuzosin or subtype-selective: tamsulosin) decreased the incidence of high-grade PCa; the decreasing trend correlated with the cumulative duration of a 1 -AR antagonists use (2).…”

313 Influence of the Neural Microenvironment in Prostate Cancer

“…38 Furthermore, clinical trials indicate that patients undergoing adrenergic receptor blockade for benign prostate hyperplasia have a lower incidence of prostate cancer than the general population. 39 However, most of this work focuses on molecules, that can be produced by cancer cells and/or excreted by nerves. In contrast, our previous work has specifically explored the relationship between that prostate cancer cells and nerves.…”

Does the autonomic nervous system contribute to the initiation and progression of prostate cancer?

“…Note that all three adrenoceptor and muscarinic receptor subtypes investigated in this study were involved in tumour initiation and/or progression. There is also epidemiological evidence to suggest that a 1 -AR antagonists may be of benefit in prostate cancer, 13,14 so their involvement in disease development also requires investigation.…”