AUA 2017: Race and Finasteride Use: Differential Impact on Bladder Cancer Risk

Boston, MA ( A recent subset analysis of the Prostate, Lung, Colorectal, and Ovarian cancer (PLCO) study has suggested that Finasteride use was associated with a reduced incidence of bladder cancer (BC) (HR=0.634, 95% confidence interval=0.493-0.816; p = 0.0004). The authors sought to validate this finding in a multiracial population in their tertiary care center.

The authors identified patients in their institutional database with Benign Prostatic Hyperplasia (BPH) based on International Classification of Diseases (ICD) 9 and 10 codes assigned between 2000 and 2016. From this cohort they identified patients who were on Finasteride and those that developed bladder cancer (BC). Multivariate logistic regression analysis was performed to determine the association of finasteride use and diagnosis of BC controlling for age, smoking history and race.

The authors identified 42,708 patients with BPH. The median follow-up was 86 months. There were 11,855 (27.8%) African Americans (AA), 11,835 (27.7%) Caucasians, and 6,332 (14.8%) Hispanics in this population. 5,689 (13.3%) patients were prescribed Finasteride. BC was diagnosed in 84 of 5,698 (1.5%) patients who were prescribed Finasteride. Multivariate logistic regression analysis showed that Finasteride use was protective of BC (OR: 0.57, CI: 0.45-0.71, p<0.001). When we stratified the data based on race, Finasteride use was protective of BC in Caucasians (2.1% vs. 3.8%, p=0.001) and Hispanics (0.8% vs. 1.6%, p=0.042), but not in AA (1.7% vs. 1.7%, p=0.854).

This study confirms previous findings from the PLCO study that Finasteride might have a protective role in BC. However, this protective role was demonstrated only in Caucasians and Hispanics and not in AA. Future research and randomized controlled studies may be needed to confirm these findings.

Presented By: Abhishek Srivastava, Bronx, NY

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA