# Impact of finasteride on modulating the risk and clinical outcomes of bladder cancer: insights from a comprehensive meta-analysis

## TL;DR

This study finds that finasteride may reduce the risk of developing bladder cancer but does not clearly affect survival outcomes.

## Contribution

The study provides the first comprehensive meta-analysis on finasteride's specific impact on bladder cancer risk and outcomes.

## Key findings

- Finasteride significantly lowers the risk of developing bladder cancer (HR: 0.75, 95% CI: 0.63–0.88).
- Subgroup analyses showed consistent preventive effects across different study regions and types.
- No significant differences were found in survival outcomes like OS, CSS, or RFS between finasteride and control groups.

## Abstract

Numerous prior analyses have highlighted a potential link between androgen suppression therapy (AST) and bladder cancer (BCa). However, there is a notable gap in research specifically examining the influence of finasteride on BCa risk and clinical outcomes. This study aimed to evaluate preventive and therapeutic value of finasteride for BCa patients.

This meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. The PubMed, Embase, Cochrane Library, and Web of Science databases were searched up to 20 December 2024, to identify studies that examined the intake of finasteride and its impact on the incidence and clinical prognosis of patients with BCa. Data was extracted for further analysis by two different reviewers who independently examined the titles and abstracts of the included articles. Subgroup analyses and leave-one-out sensitivity analyses, were applied to mitigate the potential confounding factors associated with heterogeneity.

Our investigation revealed that finasteride markedly decreased the likelihood of developing BCa (hazard ratio [HR]: 0.75, 95% confidence interval [CI]: 0.63–0.88). Subgroup analyses indicated that the preventive effect of finasteride in BCa incidence were generally consistent, regardless of study region, types of research. Furthermore, no notable disparities were observed in OS, CSS, or RFS between the finasteride group and the control group.

Finasteride plays a protective role against the progression of BCa, nevertheless, its effects on prognostic outcomes, including OS, CSS, and RFS, remain inconclusive. Additional multi-center prospective studies with long-term follow-up are required to further validate prophylactic role of finasteride on bladder cancer.

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=525046, identifier CRD42024525046.