5-Alpha Reductase Inhibitor Use and Prostate Cancer Prevention: A Victim of the Times?

The commentary by Robert J. Hamilton discusses a study by Vaselkiv and colleagues, which found no link between the use of 5-alpha reductase inhibitors (5-ARIs) and the development or death from advanced prostate cancer, indicating their long-term safety. However, due to changes in prostate cancer diagnosis and treatment, including the increased use of active surveillance for low-grade cancers and a focus on finding only clinically significant cancers, the preventative role of 5-ARIs may be becoming outdated. Despite their safety, the commentary suggests that prescribing 5-ARIs to healthy men to prevent a condition that is increasingly less significant may not be appropriate.