Abstract
Background: Preclinical evidence suggests that 5-alpha reductase inhibitors, commonly used to treat benign prostatic hyperplasia, are associated with reduced incidence of certain urological cancers, yet epidemiological studies are conflicting. This study aimed to determine whether 5-alpha reductase inhibitors are associated with a reduced risk of kidney and bladder cancers.
Methods: We conducted a new user active-comparator cohort study in the United Kingdom Clinical Practice Research Datalink. From a base cohort of patients with incident benign prostatic hyperplasia, new users of 5-alpha reductase inhibitors and alpha-blockers were identified. Patients were followed-up until a first ever diagnosis of kidney or bladder cancer, death from any cause, end of registration, or 31st 11 December 2017. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals for incident kidney and bladder cancer.
Results: There were 5,414 and 37,681 new users of 5-alpha reductase inhibitors and alpha15 blockers, respectively. During a mean follow-up of 6.3 years, we found no association between the use of 5-alpha reductase inhibitors and kidney (adjusted hazard ratio: 1.26, 95% CI 0.74-2.12, n=23) or bladder (adjusted hazard ratio: 0.89, 95% CI 0.64-1.23, n=57) cancer risk compared to alpha-blockers. Similar results were observed across sensitivity analyses.
Conclusions: In this study, we found no association between the use of 5-alpha reductase inhibitors and kidney or bladder cancer incidence in men with benign prostatic hyperplasia when compared to alpha-blocker use.
Methods: We conducted a new user active-comparator cohort study in the United Kingdom Clinical Practice Research Datalink. From a base cohort of patients with incident benign prostatic hyperplasia, new users of 5-alpha reductase inhibitors and alpha-blockers were identified. Patients were followed-up until a first ever diagnosis of kidney or bladder cancer, death from any cause, end of registration, or 31st 11 December 2017. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals for incident kidney and bladder cancer.
Results: There were 5,414 and 37,681 new users of 5-alpha reductase inhibitors and alpha15 blockers, respectively. During a mean follow-up of 6.3 years, we found no association between the use of 5-alpha reductase inhibitors and kidney (adjusted hazard ratio: 1.26, 95% CI 0.74-2.12, n=23) or bladder (adjusted hazard ratio: 0.89, 95% CI 0.64-1.23, n=57) cancer risk compared to alpha-blockers. Similar results were observed across sensitivity analyses.
Conclusions: In this study, we found no association between the use of 5-alpha reductase inhibitors and kidney or bladder cancer incidence in men with benign prostatic hyperplasia when compared to alpha-blocker use.
| Original language | English |
|---|---|
| Pages (from-to) | 428-434 |
| Number of pages | 7 |
| Journal | Cancer Epidemiology, Biomarkers and Prevention |
| Volume | 32 |
| Issue number | 3 |
| Early online date | 12 Jan 2023 |
| DOIs | |
| Publication status | Published - 6 Mar 2023 |
Bibliographical note
Financial Support: Dr’s B Hicks and CR Cardwell received funding from Cancer Research UK Population Research Fellowship (grant reference 22185). The funder had no role in the study design, analysis, interpretation or writing of the manuscriptData Availability Statement
Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).Keywords
- Benign prostatic hyperplasia
- kidney cancer
- bladder cancer
- 5-alpha reductase inhibitor
- epidemiology
Access to Document
- Doherty_etal_CEBP_Alpha_Reductase_Inhibitors_AAM
This is an accepted author manuscript of an article, that is made available by the American Association for Cancer Research. The final published version of this article is available at https://doi.org/10.1158/1055-9965.EPI-22-1109 All rights are retained by the publisher and authors