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In the Prostate Cancer Prevention Trial (PCPT), researchers found that men who received finasteride, compared with those who received placebo, experienced a 24.8% lower 7-year prevalence of prostate cancer. However, a higher proportion and number of high-grade tumors (defined as those with Gleason score 7–10) were diagnosed during the study in the finasteride group than in the placebo group. Leading urologists postulate that this result is the primary reason why finasteride chemoprevention has not been adopted widely by the urologic community. Investigators involved in the PCPT have conducted a series of post hoc evaluations to elucidate the reasons for this finding. In the current study, they assessed whether the higher prevalence of high-…