Screening for prostate cancer may fail to detect prostate cancer in a male treated with a 5-alpha reductase inhibitor (5-ARI).
Patient selection: male with benign prostatic hypertrophy treated with 5-alpha reductase inhibitor
5-alpha reductase inhibitors include finasteride and dutasteride.
Mechanism: 5-alpha reductase inhibitors reduce serum PSA by up to 50%
Risk factors for missing the diagnosis of prostate cancer:
(1) physician non-urologist unaware of effect of 5-ARIs
(2) failure to use alternative methods to screen for prostate cancer (digital rectal exam, MRI, etc)
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Specialty: Clinical Laboratory
