title: Chemoprevention of prostate cancer: an updated view.
abstract: OBJECTIVE
  To place chemoprevention of prostate cancer in current clinical context.
  
  
  METHODS
  Review of recently published updates of large, randomized, controlled trials of primary chemoprevention of prostate cancer.
  
  
  RESULTS
  With extended post-intervention follow-up, SELECT demonstrated a 17% increased risk of prostate cancer relative to placebo in the vitamin E alone arm. Two other trials in men with high-grade PIN demonstrated no effect of selenium alone or in combination with soy and lycopene. Trials of 5α-reductase inhibitors show an approximate 25% relative risk reduction in men at average risk and in those with an "elevated" PSA and prior negative biopsy, but adoption of these agents in clinical practice has been limited by concerns over an apparently increased risk of high-grade disease.
  
  
  CONCLUSIONS
  Primary prevention of prostate cancer remains an attractive goal because of its prevalence and treatment-related morbidity. Neither selenium nor vitamin E prevents prostate cancer. The benefit/risk ratio for 5α-reductase inhibitors can be improved by limiting their use to men at high risk.
authors.affiliation: Glickman Urological and Kidney Institute, Desk Q10-1, 9500 Euclid Ave, Cleveland, OH 44122, USA. kleine@ccf.org
authors.forename: Eric A
authors.initials: EA
authors.lastname: Klein
authors.forename: Ian M
authors.initials: IM
authors.lastname: Thompson
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D018890:Chemoprevention / Q000379:methods*; D006801:Humans; D008297:Male; D019048:Prostatic Intraepithelial Neoplasia / Q000188:drug therapy; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000517:prevention & control*; D012643:Selenium / Q000627:therapeutic use; D014131:Trace Elements / Q000627:therapeutic use; D014810:Vitamin E / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D058891:5-alpha Reductase Inhibitors; D014131:Trace Elements; D014815:Vitamins; D014810:Vitamin E; D012643:Selenium