James Kearns, MD, University of North Carolina School of Medicine, Chapel Hill, NC, gives an outline of the impact of 5-alpha-reductase inhibitors (5-ARIs) on prostate cancer outcomes. 5-ARIs are often used to treat lower urinary tract symptoms caused by benign prostatic hyperplasia and previous research has suggested that 5-ARI use is associated with worse prostate cancer outcomes. 5-ARIs decrease the level of prostate-specific antigen (PSA) by up to 50% making prostate cancer harder to detect and delaying diagnosis. In particular, Dr Kearns discusses the results of a retrospective cohort study investigating the impact of 5-ARI use on prostate cancer risk at the time of referral from primary care to urology. Data from 91,368 men was analyzed, including data from 2,939 5-ARI users. This interview took place during the 2021 Genitourinary Cancers Symposium.