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A drug used to shrink enlarged prostates has been shown to lower the risk of prostate cancer by 23 percent in men who have an increased risk of the disease, according to an international clinical trial presented at the American Urological Association annual meeting. A four-year, phase-III trial known as REDUCE (Reduction by Dutasteride of Prostate Cancer Events), led by Gerald L. Andriole, MD, chief of urologic surgery at Washington University School of Medicine in St. Louis and the Siteman Cancer Center, was the first to look at chemoprevention for prostate cancer in men at increased risk for the disease. 

The trial involved 8,200 men who were randomly assigned to receive a daily 0.5 mg dose of dutasteride (Avodart). Men in the study had elevated PSA levels (2.5 10 ng/ml), and they also had undergone biopsies that found no evidence of cancer within six months prior to enrolling in the trial. 

After two years, prostate cancer was found in 17.2 percent of the men who took a placebo, compared with 13.4 percent who took dutasteride. 

After four years, prostate cancer was diagnosed in another 11.8 percent of men receiving a placebo and 9.1 percent for dutasteride. Reduction in risk was constant across multiple subgroups in REDUCE. 
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