The influence of finasteride on the development of prostate cancer.
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TL;DR
Finasteride prevents or delays the appearance of prostate cancer, but this possible benefit and a reduced risk of urinary problems must be weighed against sexual side effects and the increased risk of high-grade prostate cancer.
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연도별 인용 (2012–2026) · 합계 1,125
OpenAlex 토픽 ·
Prostate Cancer Diagnosis and Treatment
Prostate Cancer Treatment and Research
Prostate Cancer Diagnosis and Treatment
🇰🇷 한글 요약 🌐 Abstract
【연구 목적】
안드로겐 의존성 종양인 전립선암(prostate cancer)의 발생을 5알파-환원효소 억제제(5α-reductase inhibitor)인 피나스테리드(finasteride)가 예방 또는 지연시킬 수 있는지를 검증하고자 함.
【방법】
55세 이상이며 직장수지검사(DRE) 정상, PSA 3.0 ng/mL 이하인 남성 18,882명을 피나스테리드 5mg/일 또는 위약군에 무작위 배정하여 7년간 추적한 Prostate Cancer Prevention Trial. 연간 PSA(피나스테리드 보정치) 4.0 ng/mL 초과 또는 DRE 이상 시 전립선 생검을 시행하였고, 1차 평가변수는 7년간 전립선암 유병률.
【주요 결과】
전립선암 발생률은 피나스테리드군 18.4%, 위약군 24.4%로 24.8% 상대위험 감소(P<0.001). 그러나 고등급(Gleason 7~10) 종양은 피나스테리드군 6.4% vs 위약군 5.1%로 오히려 증가(P=0.005). 성기능 부작용은 피나스테리드군에서, 배뇨 증상은 위약군에서 더 흔함.
【임상적 시사점 (성형외과 의사 관점)】
남성형 탈모(androgenetic alopecia)에 피나스테리드 1mg을 장기 처방할 때 환자 상담 시 본 연구를 근거로 ① 성기능 부작용 가능성, ② 전립선암 전체 발생 감소 효과는 있으나 고등급암 위험 증가 가능성을 함께 고지하는 것이 안전함. 또한 복용 중인 환자는 PSA 수치가 약 50% 낮게 측정되므로, 비뇨기과 검진 시 피나스테리드 복용 사실을 반드시 알리도록 안내해야 함.
[BACKGROUND] Androgens are involved in the development of prostate cancer. Finasteride, an inhibitor of 5alpha-reductase, inhibits the conversion of testosterone to dihydrotestosterone, the primary androgen in the prostate, and may reduce the risk of prostate cancer.
[METHODS] In the Prostate Cancer Prevention Trial, we randomly assigned 18,882 men 55 years of age or older with a normal digital rectal examination and a prostate-specific antigen (PSA) level of 3.0 ng per milliliter or lower to treatment with finasteride (5 mg per day) or placebo for seven years. Prostate biopsy was recommended if the annual PSA level, adjusted for the effect of finasteride, exceeded 4.0 ng per milliliter or if the digital rectal examination was abnormal. It was anticipated that 60 percent of participants would have prostate cancer diagnosed during the study or would undergo biopsy at the end of the study. The primary end point was the prevalence of prostate cancer during the seven years of the study.
[RESULTS] Prostate cancer was detected in 803 of the 4368 men in the finasteride group who had data for the final analysis (18.4 percent) and 1147 of the 4692 men in the placebo group who had such data (24.4 percent), for a 24.8 percent reduction in prevalence over the seven-year period (95 percent confidence interval, 18.6 to 30.6 percent; P<0.001). Tumors of Gleason grade 7, 8, 9, or 10 were more common in the finasteride group (280 of 757 tumors [37.0 percent], or 6.4 percent of the 4368 men included in the final analysis) than in the placebo group (237 of 1068 tumors [22.2 percent], P<0.001 for the comparison between groups; or 5.1 percent of the 4692 men included in the final analysis, P=0.005 for the comparison between groups). Sexual side effects were more common in finasteride-treated men, whereas urinary symptoms were more common in men receiving placebo.
[CONCLUSIONS] Finasteride prevents or delays the appearance of prostate cancer, but this possible benefit and a reduced risk of urinary problems must be weighed against sexual side effects and the increased risk of high-grade prostate cancer.
[METHODS] In the Prostate Cancer Prevention Trial, we randomly assigned 18,882 men 55 years of age or older with a normal digital rectal examination and a prostate-specific antigen (PSA) level of 3.0 ng per milliliter or lower to treatment with finasteride (5 mg per day) or placebo for seven years. Prostate biopsy was recommended if the annual PSA level, adjusted for the effect of finasteride, exceeded 4.0 ng per milliliter or if the digital rectal examination was abnormal. It was anticipated that 60 percent of participants would have prostate cancer diagnosed during the study or would undergo biopsy at the end of the study. The primary end point was the prevalence of prostate cancer during the seven years of the study.
[RESULTS] Prostate cancer was detected in 803 of the 4368 men in the finasteride group who had data for the final analysis (18.4 percent) and 1147 of the 4692 men in the placebo group who had such data (24.4 percent), for a 24.8 percent reduction in prevalence over the seven-year period (95 percent confidence interval, 18.6 to 30.6 percent; P<0.001). Tumors of Gleason grade 7, 8, 9, or 10 were more common in the finasteride group (280 of 757 tumors [37.0 percent], or 6.4 percent of the 4368 men included in the final analysis) than in the placebo group (237 of 1068 tumors [22.2 percent], P<0.001 for the comparison between groups; or 5.1 percent of the 4692 men included in the final analysis, P=0.005 for the comparison between groups). Sexual side effects were more common in finasteride-treated men, whereas urinary symptoms were more common in men receiving placebo.
[CONCLUSIONS] Finasteride prevents or delays the appearance of prostate cancer, but this possible benefit and a reduced risk of urinary problems must be weighed against sexual side effects and the increased risk of high-grade prostate cancer.
- p-value P<0.001
【연구 목적】 안드로겐 의존성 종양인 전립선암(prostate cancer)의 발생을 5알파-환원효소 억제제(5α-reductase inhibitor)인 피나스테리드(finasteride)가 예방 또는 지연시킬 수 있는지를 검증하고자 함.
APA 7
Thompson, I. M., Goodman, P. J., Tangen, C. M., Lucia, M. S., Miller, G. J., Ford, L. G., Lieber, M. M., Cespedes, R. D., Atkins, J. N., Lippman, S. M., Carlin, S. M., Ryan, A., Szczepanek, C. M., Crowley, J. J., & Coltman, C. A. (2003). The influence of finasteride on the development of prostate cancer.. The New England journal of medicine, 349(3), 215-24. https://doi.org/10.1056/NEJMoa030660
Vancouver
Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG, et al. The influence of finasteride on the development of prostate cancer. New Engl. jour. medi.. 2003;349(3):215-24. doi:10.1056/NEJMoa030660
AMA 11
Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG, et al. The influence of finasteride on the development of prostate cancer. New Engl. jour. medi.. 2003;349(3):215-24. doi:10.1056/NEJMoa030660
Chicago
Thompson, I. M., Goodman, P. J., Tangen, C. M., Lucia, M. S., Miller, G. J., Ford, L. G., Lieber, M. M., Cespedes, R. D., Atkins, J. N., Lippman, S. M., and .... 2003. "The influence of finasteride on the development of prostate cancer." The New England journal of medicine 349 (3): 215-24. https://doi.org/10.1056/NEJMoa030660
MLA 9
Thompson, I. M., et al. "The influence of finasteride on the development of prostate cancer." The New England journal of medicine, vol. 349, no. 3, 2003, pp. 215-24. doi:10.1056/NEJMoa030660.
PMID
12824459 ↗
🏷️ 키워드 / MeSH 📖 같은 키워드 OA만
인용 관계
그래프 OA 노드: 6/8 (75%)
· 참조 0편 · 후속 6편
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- Finasteride improves the sensitivity of digital rectal examination for prostate cancer detection.
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