METHODS: Review of recently published updates of large, randomized, controlled trials of primary chemoprevention of prostate cancer.
RESULTS: With extended post-intervention follow-up, SELECT demonstrated a 17% increased risk of prostate cancer relative to placebo in the vitamin E alone arm. Two other trials in men with high-grade PIN demonstrated no effect of selenium alone or in combination with soy and lycopene. Trials of 5α-reductase inhibitors show an approximate 25% relative risk reduction in men at average risk and in those with an "elevated" PSA and prior negative biopsy, but adoption of these agents in clinical practice has been limited by concerns over an apparently increased risk of high-grade disease.
CONCLUSIONS: Primary prevention of prostate cancer remains an attractive goal because of its prevalence and treatment-related morbidity. Neither selenium nor vitamin E prevents prostate cancer. The benefit/risk ratio for 5α-reductase inhibitors can be improved by limiting their use to men at high risk.
Written by:
Klein EA, Thompson IM. Are you the author?
Glickman Urological and Kidney Institute, Desk Q10-1, 9500 Euclid Ave, Cleveland, OH, 44122, USA.
Reference: World J Urol. 2012 Jan 12. Epub ahead of print.
doi: 10.1007/s00345-011-0822-9
PubMed Abstract
PMID: 22238120
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