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In a 7-year randomized placebo-controlled trial, published in 2003, the 5α-reductase inhibitor (5-ARI) finasteride was associated with overall fewer diagnoses of prostate cancer but a small increase in diagnoses of high-grade prostate cancer (NEJM JW Gen Med Aug 1 2003 and N Engl J Med 2003; 349:215). Because of this finding, the official prescribing information states that finasteride “may increase the risk of prostate cancer.” However, the excess diagnosis of high-grade tumors eventually was considered to be an artifact of enhanced detection and not a true increase in incidence (NEJM JW Gen Med Nov 1 2007 and J Natl Cancer Inst 2007; 99:1355). In a 2013 post-trial follow-up report, the researchers reported no excess mortality among recipi…