Doctors reluctant to use finasteride despite study's positive findings

According to a study published in Cancer Epidemiology, Biomarkers & Prevention (2010 Aug 10 [Epub ahead of print]), physicians have not increased their use of finasteride despite a study's findings which showed a significant reduction in prostate cancer among those taking the drug.

To examine how the results of the Prostate Cancer Prevention Trail (PCPT) may have influenced prescribing patterns among physicians, Linda Kinsinger, MD, MPH, chief consultant for preventive medicine at the Veterans Health Administration National Center for Health Promotion and Disease Prevention, and colleagues surveyed 325 urologists and 1,200 primary care physicians.

While the results of the PCPT revealed a 25% reduced risk of prostate cancer, the results of Dr. Kinsinger's study showed that physicians have not changed their practice patterns. Researchers found that 57% of urologists and 40% of primary care physicians said they prescribed finasteride more often but that only 2% said they had been influenced by the findings in PCPT. Specifically, 64% of urologists and 80% of primary care physicians never prescribe finasteride for chemoprevention.

The study authors noted that when asked for reasons for their decision, 55% of physicians said they were concerned about the risk of high-grade tumors and 52% said they did not know the drug could be used for chemoprevention.

“The use of finasteride for prostate cancer prevention dose not appear to be widely endorsed,” said Dr. Kinsinger. “The concept of chemoprevention is a difficult one for patients and physicians.”

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