Originally published as JCO Early Release 10.1200/JCO.2008.16.9599 on February 24 2009

This Article Full Text Full Text (PDF) Publisher's Note Journal of Oncology Practice Summary Erratum (v27,p2742) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kramer, B. S. Articles by Schellhammer, P. Search for Related Content PubMed PubMed Citation Articles by Kramer, B. S. Articles by Schellhammer, P. Social Bookmarking                            What's this?

Use of 5--Reductase Inhibitors for Prostate Cancer Chemoprevention: American Society of Clinical Oncology/American Urological Association 2008 Clinical Practice Guideline

From the 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.

Corresponding author: American Society of Clinical Oncology, 2318 Mill Rd, Suite 800, Alexandria, VA 22314; e-mail: guidelines{at}asco.org.

Purpose To develop an evidence-based guideline on the use of 5--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.

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 both the Journal of Clinical Oncology and Journal of Urology. Copyright © 2009 American Society of Clinical Oncology and American Urological Association. All rights reserved. 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

Approved by the American Society of Clinical Oncology Board on July 21, 2008, and by the American Urological Association Board on October 17, 2008.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				P. H. Frankel and P. Twardowski Guideline for 5-{alpha}-Reductase Inhibitors in the Prevention of Prostate Cancer Is Premature J. Clin. Oncol., October 20, 2009; 27(30): e164 - e164. [Full Text] [PDF]

				B. S. Kramer, K. L. Hagerty, M. R. Somerfield, and P. Schellhammer Reply to P.H. Frankel et al J. Clin. Oncol., October 20, 2009; 27(30): e165 - e165. [Full Text] [PDF]

				A. Lundahl, H. Lennernas, L. Knutson, U. Bondesson, and M. Hedeland Identification of Finasteride Metabolites in Human Bile and Urine by High-Performance Liquid Chromatography/Tandem Mass Spectrometry Drug Metab. Dispos., October 1, 2009; 37(10): 2008 - 2017. [Abstract] [Full Text] [PDF]

				P. C. Walsh Three Considerations Before Advising 5-{alpha}-Reductase Inhibitors for Chemoprevention J. Clin. Oncol., July 10, 2009; 27(20): e22 - e22. [Full Text] [PDF]

				B. S. Kramer, K. L. Hagerty, M. R. Somerfield, and P. Schellhammer Reply to P.C. Walsh J. Clin. Oncol., July 10, 2009; 27(20): e23 - e23. [Full Text] [PDF]

				J. Li and J. Kim Molecular Profiles of Finasteride Effects on Prostate Carcinogenesis Cancer Prevention Research, June 1, 2009; 2(6): 518 - 524. [Abstract] [Full Text] [PDF]

				Use of 5-{alpha}-Reductase Inhibitors for Prostate Cancer Chemoprevention: American Society of Clinical Oncology/American Urological Association 2008 Clinical Practice Guideline Summary J. Oncol. Pract, May 1, 2009; 5(3): 127 - 129. [Full Text] [PDF]