Prevalence of erectile dysfunction in men screened for prostate cancer

The Sexual Health Inventory for Men (SHIM) is a widely used scale for the screening and diagnosis of erectile dysfunction (ED). Our objective was to incorporate the SHIM into our prostate cancer screening program to estimate the prevalence of ED among men screened for prostate cancer.

During September 2006, men younger than 75 years of age living in the Washington, DC area were invited to participate in the George Washington University Prostate Cancer Screening Program. The SHIM questionnaire was administered to all participants. Information regarding primary care physician use, phosphodiesterase-5 inhibitor use, serum prostate-specific antigen levels, and digital rectal examination findings was also obtained. Those who registered SHIM scores of 17 or less or who were taking a phosphodiesterase-5 inhibitor were considered to have ED.

Overall, 333 men attended the program. Of the 328 men, 123 (37.5%) met our definition of ED; 30 (9%) were using a phosphodiesterase-5 inhibitor and 93 (28%) had an SHIM score of 17 or less. Univariate analysis suggested a significant difference in the prevalence of ED between African-American men and non-African-American men, with 25% and 41%, respectively, found to have a SHIM score of 17 or less (P < .01); however, this difference was not significant once we controlled for age (P > .05). Among our participants, 33% lacked a primary care physician. Of these, 22% had a SHIM score of 17 or less.

The results of our study have shown that ED increases in a nonlinear fashion with age, consistent with the findings of previous reports. Of greater concern, however, given the strong association between ED and cardiovascular disease, was the number of those with ED who lacked a primary care physician.