5ARIs and PSA: Evidence

May 2014 in “ Urologia Journal ”

Giuseppe Morgia, Daniele Urzì, Giorgio Ivan Russo

5α-reductase inhibitors serum PSA levels benign prostatic hyperplasia prostate cancer diagnostic performance digital rectal exams imaging techniques 5ARIs PSA BPH CaP

TLDR 5ARIs lower PSA levels, but other tests are needed to avoid missing aggressive prostate cancer.

The review analyzed the impact of 5α-reductase inhibitors (5ARIs) on serum PSA levels in the context of benign prostatic hyperplasia (BPH) treatment and prostate cancer (CaP) screening. It was found that 5ARIs reduced serum PSA levels for up to 48 months, enhancing the diagnostic performance of PSA in CaP screening by improving specificity. However, relying solely on PSA changes could lead to missed diagnoses of potentially aggressive tumors. Therefore, it was recommended to incorporate other diagnostic tools such as digital rectal exams, patient age, family history, and imaging techniques in clinical follow-ups to ensure comprehensive evaluation and detection of CaP.

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