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Volume 19, Issue 2 (March 2017) 19, 191–195; DOI:10.4103/1008-682X.184869

The association between sexual function and prostate cancer risk in US veterans

Daniel F Zapata1, Lauren E Howard1, Jennifer Frank2, Ross M Simon1, Cathrine Hoyo3, Delores J Grant4, Stephen J Freedland5, Adriana C Vidal5

1 Duke University Medical Center, Division of Urology, Department of Surgery, Durham, NC 27710; Durham Veterans Affairs Medical Center, Urology Division, Durham, NC 27710, USA
2 Durham Veterans Affairs Medical Center, Urology Division, Durham, NC 27710, USA
3 North Carolina State University, Department of Biology, Raleigh, NC 27695, USA
4 North Carolina Central University, Department of Biology, Durham, NC 27707, USA
5 Durham Veterans Affairs Medical Center, Urology Division, Durham, NC 27710; Department of Surgery, Division of Urology, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA

Correspondence: Dr. AC Vidal (adriana.vidal@cshs.org)

Date of Submission 14-Jan-2016 Date of Decision 06-Apr-2016 Date of Acceptance 16-Jun-2016 Date of Web Publication 30-Aug-2016


Sexual dysfunction and prostate cancer are common among older men. Few studies explored the association between these two illnesses. We examined whether sexual function is associated with prostate cancer risk among older men. Among 448 men undergoing prostate biopsy at the Durham Veterans Affairs Hospital, sexual function was ascertained from the Expanded Prostate Cancer Index Composite sexual assessment. We tested the link between sexual function and prostate cancer risk adjusting for multiple demographic and clinical characteristics using logistic regression. Multinomial logistic regression was used to test the associations with risk of low-grade (Gleason ≤6) and high-grade (Gleason ≥7 or ≥4 + 3) disease versus no cancer. Of 448 men, 209 (47%) had a positive biopsy; these men were less likely to be white (43% vs 55%, P = 0.013), had higher prostate-specific antigen (PSA) (6.0 vs 5.4 ng ml−1 , P < 0.001), but with lower mean sexual function score (47 vs 54, P = 0.007). There was no difference in age, BMI, pack years smoked, history of heart disease and/or diabetes. After adjusting for baseline differences, sexual function was linked with a decreased risk of overall prostate cancer risk (OR: 0.91 per 10-point change in sexual function, P = 0.004) and high-grade disease whether defined as Gleason ≥7 (OR: 0.86, P = 0.001) or ≥4 + 3 (OR: 0.85, P = 0.009). Sexual function was unrelated to low-grade prostate cancer (OR: 0.94, P = 0.13). Thus, among men undergoing prostate biopsy, higher sexual function was associated with a decreased risk of overall and high-grade prostate cancer. Confirmatory studies are needed.

Keywords: erectile dysfunction; prostate; prostate cancer risk; sexual function

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