Finasteride is associated with a reduction in the risk of prostate cancer (PCa), but is not associated with improved survival over 18 years, according to a study published in the New England Journal of Medicine (2013:369:603-610).

Ian M. Thompson Jr., MD, of the University of Texas Health Science Center at San Antonio, and colleagues analyzed survival rates among all participants from the Prostate Cancer Prevention Trial through Oct. 31, 2011.

Of the 18,880 eligible men who underwent randomization in the trial, the researchers found that PCa was diagnosed in 10.5% of men in the finasteride group and 14.9% of men in the placebo group, which translated into a significant 30% reduction in the relative risk of PCa.

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High-grade disease was detected in 3.5% of the men in the finasteride group versus 3.0% in the placebo group. The 15-year survival rates were 78.0% for the finasteride group and 78.2% for the placebo group. For those with low-grade prostate cancer, the 10-year survival rates were 83.0% in the finasteride group and 80.9% in the placebo group, while the 10-year survival rates were 73.0% and 73.6%, respectively, for those with high-grade disease. None of the survival differences between the groups was statistically significant.

“Data from 18 years of follow-up showed that the use of finasteride over a period of seven years in a general population of men with a median age at study entry of 63.2 years reduced the risk of prostate cancer but did not significantly affect mortality,” the authors write.