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Journal Article
Future directions in the prevention of prostate cancer
2014
Overview
Key Points
Chemoprevention has been increasingly explored to mitigate the global burden of prostate cancer and the overtreatment of indolent disease that has arisen in the prostate-specific antigen (PSA) screening era
Preclinical and epidemiological evidence suggested that selenium and α-tocopherol (vitamin E) might reduce the risk of prostate cancer
A large trial found vitamin E to significantly increase the risk of prostate cancer and selenium to have no effect on risk
The strongest evidence supports the use of 5α-reductase inhibitors for prostate cancer prevention, with recent data showing that the risk reduction with these agents is 30%
Chemoprevention has been increasingly explored to mitigate the global burden of prostate cancer and the overtreatment of indolent disease that has arisen in the prostate-specific antigen screening era. In this Review, the authors summarize the major findings of chemoprevention trials and discuss the future opportunities in this arena.
The high global incidence of prostate cancer has led to a focus on chemoprevention strategies to reduce the public health impact of the disease. Early studies indicating that selenium and vitamin E might protect against prostate cancer encouraged large-scale studies that produced mixed clinical results. Next-generation prostate cancer prevention trials validated the impact of 5α-reductase inhibitors in hormone-responsive prostate cancer, and these results were confirmed in follow-up studies. Other interventions on the horizon, involving both dietary and pharmacological agents, hold some promise but require further investigation to validate their efficacy. In this Review, we discuss the clinical and preclinical evidence for dietary and pharmacological prevention of prostate cancer and give an overview of future opportunities for chemoprevention.
Publisher
Nature Publishing Group UK,Nature Publishing Group
