Prostate cancer chemoprevention: Update of the prostate cancer prevention trial findings and implications for clinical practice

This article updates the findings of the Prostate Cancer Prevention Trial (PCPT) based on recent publications and reviews of the PCPT. New evidence shows that finasteride reduces the overall risk of prostate cancer by 30% and reduces the risk of clinically significant prostate cancer, including high-grade tumors. For tumors with Gleason scores of ≤ 6, men in the finasteride arm had a relative risk reduction (RRR) of 34% (RR, 0.66; 95% CI, 0.55–0.80; P ≤ 0.0001); tumors with Gleason scores of ≥ 7 had an RRR of 27% (RR, 0.73; 95% CI, 0.56-0.96; P = 0.02). The effect of finasteride on sexual function appears to be minimal as men on finasteride had an average 3.21 point increase on the 100 point Sexual Activity Scale compared with men on placebo. With an excellent safety profile and minimal side effects, men aged 55 years or older should be informed of the opportunity to reduce their risk of prostate cancer with finasteride.