Dr Unger also mentioned that finasteride is a low-cost generic drug that has minimal side effects.

In fact, in a previous analysis of the PCPT and linked Medicare claims, Dr Unger and colleagues looked at long-term consequences of finasteride use.3 The study showed that patients assigned to receive finasteride had a 10% increased risk for new claims for depression, but a 6% lower risk for procedures for benign prostate hyperplasia (BPH)-related events. No other differences in long-term consequences were found between finasteride or placebo arms.

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It is important to note that finasteride has not been approved by the U.S. Food and Drug Administration (FDA) for prostate cancer prevention, and is most often used for treatment of hair loss or BPH.

“There is no strong evidence of long-term detrimental effects, including sexual dysfunction, which was an initial concern,” Dr Unger said.

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According to Dr Unger, this study shows the value of using Medicare claims to extend follow-up for trial participants and answer new questions about cancer care and prevention.

“Increasingly the question for patients [with cancer] is not only how to keep them alive but how to have a good quality of life over the long-term,” Dr Unger said. “By using secondary data sources we can extend the life of trials for quite a few years to get at a difficult question of how patients are doing in the long-term. That is invaluable information for patients and researchers.”


  1. Thompson IM, Goodman PJ, Tangen CM, et al. The influence of finasteride on the development of prostate cancerN Engl J Med. 2003;349:215-224.
  2. Unger JM, Hershman DL, Till C, et al. Using Medicare claims to examine long-term prostate cancer risk of finasteride in the Prostate Cancer Prevention Trial [published online March 9, 2018]. J Natl Cancer Inst. doi: 10.1093/jnci/djy035
  3. Unger JM, Till C, Thompson IM Jr, et al. Long-term consequences of finasteride vs placebo in the Prostate Cancer Prevention Trial. J Natl Cancer Inst. 2016;108(12). doi: 10.1093/jnci/djw168