Liss Michael A, Thompson Ian M
Department of Urology (liss), University of Texas Health San Antonio.
CHRISTUS Santa Rosa Medical Center Hospital, CHRISTUS Research Institute, San Antonio, Texas, USA.
Curr Opin Urol. 2018 Jan;28(1):42-45. doi: 10.1097/MOU.0000000000000464.
We review the concepts surrounding prostate cancer prevention strategies with 5-alpha reductase inhibitors (5-ARIs) and the controversies associated with their use.
Updated data have shown no increased risk of death from the diagnosis of higher risk cancer; however, 5-ARIs remain controversial and not approved for prostate cancer prevention.
The main theme of the review identifies the success of reducing insignificant prostate cancer and the controversy with the increased association of higher risk prostate cancer by approximately 20%. The reduction was shown to be most significant reduction in low-grade prostate cancer. The initial concern about 5-ARI use was that it could potentially increase high-risk prostate cancer leading to higher mortality in those men. Higher mortality has not been seen in follow-up data; however, 5-ARIs continue to have a black box warning and are not approved for prostate cancer prevention.
我们回顾了围绕使用5α还原酶抑制剂（5-ARIs）进行前列腺癌预防策略的相关概念以及与其使用相关的争议。
更新数据显示，诊断为高风险癌症后死亡风险并未增加；然而，5-ARIs仍存在争议，未被批准用于前列腺癌预防。
综述的主要主题是确定在减少无意义前列腺癌方面取得的成功，以及与高风险前列腺癌关联增加约20%相关的争议。研究表明，这种减少在低级别前列腺癌中最为显著。最初对使用5-ARIs的担忧是，它可能会增加高风险前列腺癌，导致这些男性的死亡率更高。随访数据中未发现更高的死亡率；然而，5-ARIs仍然有黑框警告，未被批准用于前列腺癌预防。
