More on Long-Term Effects of Finasteride on Prostate Cancer Mortality

Abstract

To the Editor: In their letter to the Editor, Goodman et al. (Jan. 24 issue)¹ report on remaining concerns about the association between finasteride and high-grade prostate cancer (defined as a tumor with a Gleason score of 7 to 10; the Gleason score is the sum of the two most common histologic patterns or grades in a prostate tumor, each of which is graded on a scale of 1 to 5, with 5 being the most cytologically aggressive). Bias due to overdetection of high-grade prostate cancer² may play a role in this association, but the effect of a reduced prostate-specific . . .