To the Editor Interpretation of observational studies is challenging when results are different from randomized trials.1 The recently published report by Sarkar and colleagues2 illustrates this challenge. A retrospective cohort of patients diagnosed with prostate cancer between 2001 and 2005 was described, and it was found that the use of 5-α reductase inhibitors (5-ARIs) was associated with a delayed diagnosis and a 39% increase in prostate cancer mortality. Initially, this conclusion seems at variance with the follow-up report of the randomized Prostate Cancer Prevention Trial, which showed no increase in prostate cancer mortality in men receiving finasteride compared with placebo.3
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Thompson IM, Tangen CM, Kramer B. 5α-Reductase Inhibitor Use in Patients With Prostate Cancer. JAMA Intern Med. 2019;179(10):1440. doi:10.1001/jamainternmed.2019.3626
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