Should all men or only a high-risk subgroup be treated with Finasteride?

It has been shown that Finasteride reduces the incidence of prostate cancer. Yet the use of finasteride remains low, likely because of the risk of adverse effects.  A new study at Memorial Sloan-Kettering Cancer Center aimed to determine whether prostate-specific antigen (PSA) levels could identify a high-risk subgroup for which the benefits of finasteride treatment outweigh the potential harms.

Researchers concluded that wishing to reduce the risk of any biopsy-detectable prostate cancer clinicians should recommend finasteride to all men. They who believe that it is unnecessary to prevent all cancers, but that preventing those readily detectable by screening would be desirable, would be best off recommending finasteride only to a high-risk subgroup.