Eur J Cancer. 2007;43:775-781
Men who take finasteride or alpha blockers for BPH are at higher risk of prostate cancer than non-users, investigators in Finland conclude.

The finding is based on a study of 25,029 newly diagnosed pros-tate cancer cases and 24,723 male controls. A total of 7,715 men (15.6% of the total study population) had used BPH pharmacotherapy (finasteride, tamsulosin, and alfuzosin).

Overall, finasteride and alpha-blocker use were asso-ciated with a 41% and 79% in-creased risk of prostate cancer, respectively, compared with non-use. Users of both medication categories had a 49% increased risk compared with non-users.

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The investigators, led by Teemu J. Murtola, MD, of the University of Tampere, noted that their study is the first “to examine prostate cancer risk among finasteride users in a population-based setting and compare it to that of alpha-blocker users.”
The increased prostate cancer risk in users of BPH pharmacotherapy “is due to enhanced detection of latent prostate cancers associated with clinical practice of BPH diagnosis and management,” the au-thors wrote. They pointed out, however, that the risk was lower among finasteride users than among alpha-blocker users, “who are subject to similar diagnostics.”
“These results suggest a chemopreventive effect of finasteride on prostate cancer at the population level in men treated for BPH,” they noted. “Nevertheless, possible detection bias caused by the PSA lowering effect of finasteride must be considered when interpreting the results.”