Knowledge and use of finasteride for the prevention of prostate cancer.
BACKGROUND
The knowledge about and use of chemopreventive agents for prostate cancer by physicians has not been described. The Prostate Cancer Prevention Trial (PCPT) showed that finasteride was effective in reducing the incidence of prostate cancer. We examined the influence of the PCPT on finasteride prescribing within the Veterans Health Administration (VHA).


METHODS
We assessed trends on monthly new and total prescriptions for finasteride filled within the VHA from January 2000 to December 2005. Additionally, all VHA urologists and a random sample of VHA primary care physicians (PCP) were surveyed about their use of finasteride.


RESULTS
The number of men starting finasteride grew over the study period. Publication of the PCPT was not significantly associated with any change in this pattern (P = 0.45). Fifty-seven percent of urologists and 40% of PCPs endorsed prescribing finasteride more frequently in 2006 than 5 years prior. However, among those who reported changing prescribing patterns, fewer than 2% reported being influenced by the PCPT. Sixty-four percent of urologists and 80% of PCPs never prescribe finasteride for prostate cancer chemoprevention; 55% of urologists cited concerns of inducing high-grade tumors, whereas 52% of PCPs did not know it could be used for chemoprevention.


CONCLUSIONS
The number of men starting finasteride in the VHA increased over time, but the change did not seem to be due to increased use of finasteride for chemoprevention. Publication of the PCPT seemed to have little influence over the study period.


CONCLUSIONS
Physicians may not readily accept the use of chemopreventive agents for prostate cancer.
Hamilton
Robert J
RJ
Division of Urologic Surgery, Department ofSurgery, Duke University School of Medicine, Durham, North Carolina, USA.
Kahwati
Leila C
LC
Kinsinger
Linda S
LS
D016588:Anticarcinogenic Agents / Q000008:administration & dosage*; D003625:Data Collection; D018120:Finasteride / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D008297:Male; D010818:Practice Patterns, Physicians' / Q000639:trends*; D055656:Prescriptions / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs
D016588:Anticarcinogenic Agents; D018120:Finasteride