Baseline prevalence of erectile dysfunction in a prostate cancer screening population

Introduction. Erectile dysfunction (ED) is common in older men and can be worsened by prostate cancer (PCa) treatment. True ED rates before PCa treatment are mandatory, in order to assess the rate of ED attributable to PCa treatment. Data derived from population-based studies or from patients surveyed after PCa diagnosis, as well as just prior to treatment may not represent a valid benchmark, as health profiles of the general population might be different to those undergoing PCa screening or as anxiety may worsen existent ED. Aim. To circumvent these limitations, we assessed the baseline rate of ED in PCa diagnosis-free men participating in a PCa awareness event. Methods. ED was classified according to the International Index of Erectile Function (IIEF) score as absent (IIEF: 25-30), mild (22-24), mild to moderate (17-21), moderate (11-16), or severe (<= 10). Analyses were adjusted according to age and socioeconomic status. Main Outcome Measures. Of 1,273 asymptomatic men who participated in the event, 1,134 (89.1%) completed the IIEF score. Results. Mean age was 57.6 years (range 40-89 years). Of all participating men, 50.0% (N = 566) were potent, 8.8% (N, = 100) reported mild, 10.4% (N = 118) mild to moderate, 9.4% (N = 107) moderate, and 21.4% (NT = 243) severe ED. Men with ED were significantly older (P<0.001), had no stable partner (P<0.001), lower education (P < 0.001), and lower annual income (P < 0.001) than men without ED. Conclusions. One in two men who participated in this PCa awareness event is affected by ED, independent of PCa diagnosis or treatment. Such high prevalence of baseline ED in a PCa screening cohort suggests that in patients treated for PCa, ED may represent a common disorder already present prior to treatment. Moreover, socioeconomic variables were seen to have an important influence on erectile function in this patient cohort.