Use of 5-alpha-reductase inhibitors (5-ARIs) is associated with a lower risk of dying from bladder cancer among men newly diagnosed with the malignancy, researchers reported at the 33rd European Association of Urology Congress in Copenhagen, Denmark.

In a study of 10,720 men newly diagnosed with bladder cancer during 1997 to 2012, first author Ville J. Mäkelä, a medical student at the University of Tampere in Finland, and colleagues found that 5-ARI use before diagnosis and after diagnosis was associated with a significant 15% and 22% decreased risk of bladder cancer-specific death, respectively, compared with non-use. Results also showed that pre- and post-diagnostic use of alpha-blockers was not associated with death from bladder cancer. The investigators included alpha-blockers in their study to account for possible confounding by indication, such as concomitant BPH, for which both alpha-blockers and 5-ARIs are prescribed.

The study supports the role of androgens and benefits of 5-alpha-reductase inhibition in the progression of bladder cancer, the investigators concluded.

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The study consisted of 3208 5-ARI users (1328 before bladder cancer diagnosis and 1880 after diagnosis), 6603 alpha-blocker users (2353 before diagnosis and 4250 after diagnosis), and 5090 non-users of either medication class.

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The men who used 5-ARIs before and after diagnosis had a median age of 78 and 75 years, respectively. The men who used alpha-blockers before after diagnosis had a median age of 76 and 74 years. Non-users had a median age of 70 years. In all groups, the majority of tumors were localized.


Mäkelä VJ, Kotsar A, Tammela TL, Murtola TJ. Bladder cancer survival in men using 5-alpha-reductase inhibitors. Data presented at the 33rd European Association of Urology Congress in Copenhagen, Denmark.