PCPT:
- 18 000 men; 9000 available for results; normal DRE and PSA < 3 ; biopsy at 7 years, or if PSA > 4 / abnormal DRE
- 25 % reduction in overall prostate cancer in men taking finasteride vs placebo
- Most of the reduction in cancer was of Gleason 6 cancers
- Of the cancers found, there was a higher prevalence of Gleason 8 – 10 cancers in the finasteride group
- ? smaller prostate secondary to finasteride increased the chance of finding the higher risk cancer
- Higher rates of upgrading to Gleason 7 + in those who underwent RP for Gleason 6 or less
- 15 year follow up – no difference in overall survival between groups (including subgroup analysis of those diagnosed with cancer)
REDUCE:
- Included 6700 men with a negative biopsy 6 – 12 months before enrolment
- Dutasteride reduced risk of prostate cancer by 23 % over 4 years
- No overall difference in detection of Gleason 7 – 10 cancers over the study period, there was an increased risk for Gleason 8 – 10 in years 3 – 4 in the dutasteride group
