Gerald L. Andriole Jr., MD, presented “5-Alpha Reductase Inhibitors Increase the Risk of Aggressive Prostate Cancer: Fact or Myth” during the 44th Annual Ralph E. Hopkins Urology Seminar on February 7, 2025, in Jackson Hole, Wyoming.
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How to cite: Andriole, Gerald L. “5-Alpha Reductase Inhibitors Increase the Risk of Aggressive Prostate Cancer: Fact or Myth.” February 7, 2025. Accessed Mar 2026. https://grandroundsinurology.com/5-alpha-reductase-inhibitors-increase-the-risk-of-aggressive-prostate-cancer-fact-or-myth/
5-Alpha Reductase Inhibitors Increase the Risk of Aggressive Prostate Cancer: Fact or Myth – Summary
Gerald L. Andriole, Jr., MD, challenges misconceptions about five-alpha reductase inhibitors (5-ARIs) in urology, focusing on their role in prostate cancer. In this 14-minute presentation, Dr. Andriole notes that interest in 5-ARIs and cancer prevention originates from BPH trials, where cancer incidence was lower among treated patients.
Dr. Andriole shares details from the Prostate Cancer Prevention Trial, which showed a 20% reduction in cancer detection with finasteride. The REDUCE trial, focused on high-risk patients, confirmed a 23% reduction in cancer with dutasteride without increasing high-grade tumors.
Long-term studies refute concerns about aggressive cancers. Scandinavian and US analyses confirm reduced overall cancer detection and no increased risk of advanced disease. A refined PSA interpretation strategy—detecting a 0.3 ng/mL rise from nadir rather than PSA doubling—improves cancer detection in 5-ARI users. The findings reinforce 5-ARIs’ role in reducing prostate cancer risk without increasing mortality.
About The 44th Annual Ralph E. Hopkins Urology Seminar:
The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, sexual function, emerging surgical techniques, and general urology. The 44th iteration of the meeting took place from February 5th to February 8th, 2025, in Jackson Hole, Wyoming.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Gerald L. Andriole, Jr., MD, is the Chief Medical Officer of Prostatype Genomics AB in St. Louis, Missouri. Dr. Andriole is an internationally recognized key opinion leader in urology with a significant focus on prostate cancer. His research and clinical experience, much of which focuses on genomic testing, allows him to continue to positively impact the quality of care and outcomes for patients diagnosed with prostate cancer.
