The PCPT (Prostate Cancer Prevention Trial) demonstrated which unexpected finding regarding 5α-reductase inhibitors?

• A Finasteride had no effect on prostate cancer incidence
• B Finasteride eliminated the risk of prostate cancer when taken for >7 years
• C Finasteride significantly reduced PSA-detected cancers but increased prostate cancer mortality
• D Finasteride reduced overall prostate cancer incidence by 25% but was associated with a higher rate of high-grade (Gleason 7–10) prostate cancer in the finasteride group ✓

Explanation

The PCPT (Thompson et al., 2003) showed that finasteride reduced overall prostate cancer prevalence by ~25%; however, the finasteride group had a paradoxically higher rate of high-grade (Gleason 7–10) cancer (6.4% vs. 5.1%). Subsequent analyses suggested this may partly reflect a 'detection bias' — finasteride shrinks the gland, making biopsies more likely to detect high-grade foci — rather than a true induction of high-grade cancer. This finding created controversy and led to FDA black-box labeling. Finasteride is not approved for cancer chemoprevention.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.