Physicians Reluctant to Use Chemoprevention for Prostate Cancer

A study published in the September issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research says that despite excellent results of the Prostate Cancer Prevention Trial (PCPT), which showed a significant reduction in prostate cancer among those taking finasteride, physicians have not increased its use. The first results of the PCPT were published in 2003 in The New England Journal of Medicine and were widely reported. The randomized controlled trial consisted of 18,000 men and showed a 25 percent reduced risk of prostate cancer.

Unfortunately, it also showed a 27 percent increased risk in high-grade tumors, which was noted in an accompanying editorial. Ian Thompson, M.D., chairman of the department of urology at the University of Texas Health Science Center, who led the study, said the editorial may have colored the perception of finasteride.

"People tend to read editorials more than they read actual journal articles," said Thompson. "The study paradox of a reduction in overall disease, but an increase in high-grade disease was not explored until much later."

In 2008, another report was published in Cancer Prevention Research, another journal of the AACR, where Thompson and colleagues reanalyzed the data along with the available tumor biopsies. Results showed that finasteride did not actually increase risk; it just made the available testing more sensitive. This result confirmed the benefits of finasteride for prostate cancer prevention.

However, results of this new study showed that physicians have not changed their practice patterns.

Linda Kinsinger, M.D., M.P.H., chief consultant for preventive medicine at the Veterans Health Administration National Center for Health Promotion and Disease Prevention, and colleagues surveyed 325 urologists and 1,200 primary care physicians to determine their prescribing patterns.

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Source-Eurekalert