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5α-reductase inhibitors (5-ARI) are widely employed for the treatment of benign prostatic hyperplasia.It has been noted that 5-ARI exhibit the potential to attenuate the risk of prostate cancer,but consistent agreement has not been achieved.Moreover,the effect of 5-ARI on cancer-specific mortality and progression of prostate cancer remains unclear.Therefore,the goal of the current meta-analysis was to elucidate the impact of 5-ARI on the incidence and progression of prostate cancer.We searched for all studies assessing the effect of 5-ARI on risk of prostate cancer in PubMed,Embase,Medline,and Cochrane Library databases.Pooled relative risk (RR) and corresponding 95％ confidence intervals (CIs) were accepted to evaluate the association between 5-ARI and the risk of prostate cancer.Synthetic results implied that subjects who accepted 5-ARI compared with the placebo group experienced a distinctly weakened overall incidence of prostate cancer (RR =0.74;95％ CI: 0.66-0.82;P ＜ 0.001).Subgroup analyses further revealed that 5-ARI reduction of the incidence of prostate cancer was limited to low-grade (Gleason score 2-6;RR =0.68;95％ CI: 0.57-0.81;P ＜ 0.001) and intermediate-grade tumors (Gleason score 7;RR =0.81;95％ CI: 0.67-0.97;P =0.023),but not high-grade tumors (Gleason score ＞7;RR =1.19;95％ CI: 0.98-1.43;P =0.069).The results also showed that 5-ARI treatment did not significantly alter prostate cancer-specific mortality (RR =1.0;95％ Cl: 0.95-1.05;P =0.916).In addition,it was worth noting that 5-ARI treatment acted in a protective role that presented a dramatic benefit to delay the progression of low-risk tumors (RR =0.58;95％ CI: 0.43-0.78;P ＜ 0.001).