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Prevalence of undiagnosed prostate cancer in men with erectile dysfunction
K Sairam1, E Kulinskaya, G B Boustead
1Lister Hospital, Stevenage, and Health Research & Development Support Unit (HRDSU), Faculty of Health & Human Sciences, University of Hertfordshire, Hatfield, Herts, UK.
Objective:
To explore the prevalence of prostate cancer in men presenting with erectile dysfunction (ED).
Patients And Methods:
In a prospective study, 127 men with ED of at least 6 months duration underwent screening for prostate cancer using prostate specific antigen (PSA) and a digital rectal examination (DRE). Men with a high PSA level (> 4 ng/mL) had sextant biopsies taken under sedoanalgesia. The serum testosterone level was measured in all the men.
Results:
Twenty-six men were aged < 50 years and all had a normal PSA level; of 101 men aged > 50 years, 20 had an abnormal PSA. The detection rate for prostate cancer using PSA and DRE was 5%, which was not significantly higher than in the general population. All the detected cancers were clinically significant (> T2a, Gleason grade > 4). Two of the five men diagnosed with prostate cancer were Afro-Caribbean. Of the 127 men, 31% had a low serum testosterone level, but there was no association between testosterone and PSA levels.
Conclusions:
Prostate cancer is no more common in men with ED than in the normal male population. Therefore, routine screening for prostate cancer in men with ED is not indicated.