title: The association between sexual function and prostate cancer risk in US veterans.
abstract: 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.
authors: Duke University Medical Center, Division of Urology, Department of Surgery, Durham, NC 27710, USA.|Durham Veterans Affairs Medical Center, Urology Division, Durham, NC 27710, USA.
authors: Daniel F
authors: DF
authors: Zapata
authors: Duke University Medical Center, Division of Urology, Department of Surgery, Durham, NC 27710, USA.|Durham Veterans Affairs Medical Center, Urology Division, Durham, NC 27710, USA.
authors: Lauren E
authors: LE
authors: Howard
authors: Durham Veterans Affairs Medical Center, Urology Division, Durham, NC 27710, USA.
authors: Jennifer
authors: J
authors: Frank
authors: Duke University Medical Center, Division of Urology, Department of Surgery, Durham, NC 27710, USA.|Durham Veterans Affairs Medical Center, Urology Division, Durham, NC 27710, USA.
authors: Ross M
authors: RM
authors: Simon
authors: North Carolina State University, Department of Biology, Raleigh, NC 27695, USA.
authors: Cathrine
authors: C
authors: Hoyo
authors: North Carolina Central University, Department of Biology, Durham, NC 27707, USA.
authors: Delores J
authors: DJ
authors: Grant
authors: Durham Veterans Affairs Medical Center, Urology Division, Durham, NC 27710, USA.|Department of Surgery, Division of Urology, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
authors: Stephen J
authors: SJ
authors: Freedland
authors: Durham Veterans Affairs Medical Center, Urology Division, Durham, NC 27710, USA.|Department of Surgery, Division of Urology, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
authors: Adriana C
authors: AC
authors: Vidal
mesh_terms: D000367:Age Factors; D000368:Aged; D001706:Biopsy; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology; D007172:Erectile Dysfunction / Q000453:epidemiology*; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*
chemical_list: D017430:Prostate-Specific Antigen