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Influence of 5-Alpha Reductase Inhibitors on PI-RADS Scores and Prostate Cancer Detection: A Systematic Review and Meta-Analysis

  • 0Department of Radiology, Lanzhou University Second Hospital, Lanzhou, Gansu, P.R. China.
The Prostate +

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September 29, 2025

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September 29, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

5-alpha reductase inhibitors (5-ARIs) do not significantly affect prostate cancer (PCa) detection or Prostate Imaging Reporting and Data System (PI-RADS) classifications. This means 5-ARI use should not alter MRI-based diagnostic strategies for suspected PCa.

Area Of Science

  • Urology
  • Radiology
  • Oncology

Background

  • 5-alpha reductase inhibitors (5-ARIs) are commonly used for benign prostatic hyperplasia and prostate cancer (PCa).
  • The potential impact of 5-ARIs on Prostate Imaging Reporting and Data System (PI-RADS) classifications and PCa detection requires clarification.

Purpose Of The Study

  • To systematically review and analyze the influence of 5-ARIs on PI-RADS tumor classifications.
  • To evaluate the effect of 5-ARIs on PCa detection rates.

Main Methods

  • A comprehensive systematic review and meta-analysis of published studies.
  • Searches conducted across Web of Science, PubMed, and Embase databases.
  • Statistical analysis performed using STATA v.16.0.

Main Results

  • Seven studies involving 12,132 participants were included.
  • No significant difference in PCa diagnosis (OR 0.97, 95% CI 0.86-1.08) or clinically significant PCa (csPCa) diagnosis (OR 1.01, 95% CI 0.89-1.16) was observed between 5-ARI users and non-users.
  • Subgroup analyses showed comparable PCa diagnosis across PI-RADS 3, 4, and 5 categories for 5-ARI-exposed men.

Conclusions

  • 5-ARIs do not significantly alter PI-RADS lesion distribution.
  • Exposure to 5-ARIs does not impact the diagnosis of PCa or csPCa.
  • MRI-based diagnostic approaches for suspected PCa should not be influenced by 5-ARI use.

Keywords:

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