5-Alpha Reductase Inhibitors and Risk of Kidney and Bladder Cancers in Men with Benign Prostatic Hyperplasia: A Population-Based Cohort Study

Niamh Doherty* (Corresponding Author), Chris R Cardwell, Peter Murchie, Christopher Hill, Laurent Azoulay, Blánaid Hicks

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.
Original languageEnglish
JournalCancer Epidemiology, Biomarkers and Prevention
Early online date12 Jan 2023
DOIs
Publication statusE-pub ahead of print - 12 Jan 2023

Keywords

  • Benign prostatic hyperplasia
  • kidney cancer
  • bladder cancer
  • 5-alpha reductase inhibitor
  • epidemiology

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