Use of 5α-Reductase Inhibitors for Prostate Cancer Chemoprevention: American Society of Clinical Oncology/American Urological Association 2008 Clinical Practice Guideline
published online 26 February 2009.
Refers to article:
A Guideline for Discussion and Some Thoughts
, 26 February 2009
Michael J. Droller
The Journal of Urology
April 2009 (Vol. 181, Issue 4, Pages 1530-1531) Full Text |
Full-Text PDF (93 KB)
Bcl2 −938C/A Polymorphism Carries Increased Risk of Biochemical Recurrence After Radical Prostatectomy
, 23 February 2009
Hiroshi Hirata, Yuji Hinoda, Nobuyuki Kikuno, Yutaka Suehiro, Varahram Shahryari, Ardalan E. Ahmad, Z. Laura Tabatabai, Mikio Igawa, Rajvir Dahiya
The Journal of Urology
April 2009 (Vol. 181, Issue 4, Pages 1907-1912) Abstract |
Full Text |
Full-Text PDF (365 KB)
Purpose
To develop an evidence-based guideline on the use of 5-α-reductase inhibitors (5-ARIs) for prostate cancer chemoprevention.
Methods
The American Society of Clinical Oncology (ASCO) Health Services Committee (HSC), ASCO Cancer Prevention Committee, and the American Urological Association Practice Guidelines Committee jointly convened a Panel of experts, who used the results from a systematic review of the literature to develop evidence-based recommendations on the use of 5-ARIs for prostate cancer chemoprevention.
Results
The systematic review completed for this guideline identified 15 randomized clinical trials that met the inclusion criteria, nine of which reported prostate cancer period prevalence.
Conclusion
Asymptomatic men with a prostate-specific antigen (PSA) ≤3.0 ng/mL who are regularly screened with PSA or are anticipating undergoing annual PSA screening for early detection of prostate cancer may benefit from a discussion of both the benefits of 5-ARIs for 7 years for the prevention of prostate cancer and the potential risks (including the possibility of high-grade prostate cancer). Men who are taking 5-ARIs for benign conditions such as lower urinary tract [obstructive] symptoms (LUTS) may benefit from a similar discussion, understanding that the improvement of LUTS relief should be weighed with the potential risks of high-grade prostate cancer from 5-ARIs (although the majority of the Panel members judged the latter risk to be unlikely). A reduction of approximately 50% in PSA by 12 months is expected in men taking a 5-ARI; however, because these changes in PSA may vary across men, and within individual men over time, the Panel cannot recommend a specific cut point to trigger a biopsy for men taking a 5-ARI. No specific cut point or change in PSA has been prospectively validated in men taking a 5-ARI.
National Institutes of Health, Bethesda, MD; American Society of Clinical Oncology, Alexandria, VA; University of Montana Liberal Studies, Missoula, MT; University of Connecticut Health Center, Farmington, CT; International Epidemiology Institute, Rockville, MD; Johns Hopkins University, Baltimore, MD; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Minnesota School of Medicine, Minneapolis, MN; Statistics Collaborative,Washington, DC; Michiana Hematology Oncology, Granger, IN; and Eastern Virginia Medical School, Norfolk, VA
Approved by the American Society of Clinical Oncology Board on July 21, 2008, and by the American Urological Association Board on October 17, 2008.
This document is being reprinted as submitted without editorial or independent peer review by the Editors of The Journal of Urology®.
This guideline was developed through a collaboration between the American Society of Clinical Oncology and the American Urological Association, and has been published jointly by invitation and consent in the Journal of Clinical Oncology and The Journal of Urology®. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording or any information storage and retrieval system, without written permission by the American Society of Clinical Oncology or the American Urological Association.
See Editorial on page 1530.
For another article on a related topic see page 1907.
⁎ Financial interest and/or other relationship with GlaxoSmithKline.
† Financial interest and/or other relationship with GlaxoSmithKline.
‡ Financial interest and/or other relationship with Merck.
§ Financial interest and/or other relationship with Theralogix, Dendreon Corporation, Southwestern Oncology Group and ContraVac.
ABSTRACT