In Reply We would like to thank Gann for his important perspective on this topic and for his interest in our study.1 In his letter, Gann notes an important modeling article that takes the size of the prostate into account when determining the effect of use of a 5-α reductase inhibitor (5-ARI) on the development of low-grade and high-grade prostate cancers.2 There is extensive debate in the literature on whether 5-ARIs directly increase the risk of high-grade cancers through some biologic mechanism. Although this is still an open question, the majority of the data seems to suggest that use of 5-ARIs does not directly increase this risk. Owing to the inherent limitations in observational data, we do not feel that our study meaningfully contributes to this question.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Sarkar RR, Rose BS. Benefits of Targeted Use of 5α-Reductase Inhibitors in Patients With Prostate Cancer—Reply. JAMA Intern Med. 2019;179(10):1442. doi:10.1001/jamainternmed.2019.3890
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: