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High-Grade Prostate Cancer, Prostate Volume, and Finasteride
The Prostate Cancer Prevention Trial (PCPT) reported that patients taking finasteride, a 5
-reductase inhibitor, had a decreased incidence of prostate cancer overall. However, the incidence of high-grade cancer was higher in the finasteride group than the placebo group. One possible explanation for this increase is that finasteride induces high-grade tumors, but several other mechanisms could also explain it.
To investigate whether the increase could be due to finasteride's influence on prostate volume or tumor morphology, Lucia et al. (p. 1375) examined prostate biopsy samples from PCPT participants with high Gleason scores for hormonal effects and pathologic
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