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Ejaculation Frequency and Risk of Prostate Cancer: Updated Results after a Decade
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<blockquote data-quote="Nelson Vergel" data-source="post: 35770" data-attributes="member: 3"><p>Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow-up</p><p></p><p>By: Jennifer R. Ridera b 1 &#8270; , Kathryn M. Wilsona c 1, Jennifer A. Sinnotta d, Rachel S. Kellyc, Lorelei A. Muccia c and Edward L. Giovannuccia c e</p><p></p><p>European Urology, March 2016</p><p></p><p>Published online: 29 March 2016</p><p></p><p>Keywords: Epidemiology, Ejaculation, Behavioral risk factors</p><p></p><p></p><p>Abstract</p><p></p><p>Background</p><p></p><p>Evidence suggests that ejaculation frequency may be inversely related to the risk of prostate cancer (PCa), a disease for which few modifiable risk factors have been identified.</p><p></p><p>Objective</p><p></p><p>To incorporate an additional 10 yr of follow-up into an original analysis and to comprehensively evaluate the association between ejaculation frequency and PCa, accounting for screening, clinically relevant disease subgroups, and the impact of mortality from other causes.</p><p></p><p>Design, setting, and participants</p><p></p><p>A prospective cohort study of participants in the Health Professionals Follow-up Study utilizing self-reported data on average monthly ejaculation frequency. The study includes 31&#8194;925 men who answered questions on ejaculation frequency on a 1992 questionnaire and followed through to 2010. The average monthly ejaculation frequency was assessed at three time points: age 20&#8211;29 yr, age 40&#8211;49 yr, and the year before questionnaire distribution.</p><p></p><p>Outcome measurements and statistical analysis</p><p></p><p>Incidence of total PCa and clinically relevant disease subgroups. Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).</p><p></p><p>Results and limitations</p><p></p><p>During 480&#8194;831 person-years, 3839 men were diagnosed with PCa. Ejaculation frequency at age 40&#8211;49 yr was positively associated with age-standardized body mass index, physical activity, divorce, history of sexually transmitted infections, and consumption of total calories and alcohol. Prostate-specific antigen (PSA) test utilization by 2008, number of PSA tests, and frequency of prostate biopsy were similar across frequency categories. In multivariable analyses, the hazard ratio for PCa incidence for &#8805;21 compared to 4&#8211;7 ejaculations per month was 0.81 (95% confidence interval [CI] 0.72&#8211;0.92; p&#8194;<&#8194;0.0001 for trend) for frequency at age 20&#8211;29 yr and 0.78 (95% CI 0.69&#8211;0.89; p&#8194;<&#8194;0.0001 for trend) for frequency at age 40&#8211;49 yr. Associations were driven by low-risk disease, were similar when restricted to a PSA-screened cohort, and were unlikely to be explained by competing causes of death.</p><p></p><p>Conclusions</p><p></p><p>These findings provide additional evidence of a beneficial role of more frequent ejaculation throughout adult life in the etiology of PCa, particularly for low-risk disease.</p><p></p><p>Patient summary</p><p></p><p>We evaluated whether ejaculation frequency throughout adulthood is related to prostate cancer risk in a large US-based study. We found that men reporting higher compared to lower ejaculatory frequency in adulthood were less likely to be subsequently diagnosed with prostate cancer.</p><p></p><p>Take Home Message</p><p></p><p><strong>In a large prospective study with long-term follow-up, men who reported more frequent ejaculation in adulthood had a lower risk of total incidence of prostate cancer. Ejaculation frequency represents a potentially modifiable risk factor for prostate cancer.</strong></p><p></p><p>Keywords: Epidemiology, Ejaculation, Behavioral risk factors.</p><p></p><p>Footnotes</p><p>a Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA</p><p></p><p>b Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA</p><p></p><p>c Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA</p><p></p><p>d Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA</p><p></p><p>e Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA</p></blockquote><p></p>
[QUOTE="Nelson Vergel, post: 35770, member: 3"] Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow-up By: Jennifer R. Ridera b 1 ⁎ , Kathryn M. Wilsona c 1, Jennifer A. Sinnotta d, Rachel S. Kellyc, Lorelei A. Muccia c and Edward L. Giovannuccia c e European Urology, March 2016 Published online: 29 March 2016 Keywords: Epidemiology, Ejaculation, Behavioral risk factors Abstract Background Evidence suggests that ejaculation frequency may be inversely related to the risk of prostate cancer (PCa), a disease for which few modifiable risk factors have been identified. Objective To incorporate an additional 10 yr of follow-up into an original analysis and to comprehensively evaluate the association between ejaculation frequency and PCa, accounting for screening, clinically relevant disease subgroups, and the impact of mortality from other causes. Design, setting, and participants A prospective cohort study of participants in the Health Professionals Follow-up Study utilizing self-reported data on average monthly ejaculation frequency. The study includes 31 925 men who answered questions on ejaculation frequency on a 1992 questionnaire and followed through to 2010. The average monthly ejaculation frequency was assessed at three time points: age 20–29 yr, age 40–49 yr, and the year before questionnaire distribution. Outcome measurements and statistical analysis Incidence of total PCa and clinically relevant disease subgroups. Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results and limitations During 480 831 person-years, 3839 men were diagnosed with PCa. Ejaculation frequency at age 40–49 yr was positively associated with age-standardized body mass index, physical activity, divorce, history of sexually transmitted infections, and consumption of total calories and alcohol. Prostate-specific antigen (PSA) test utilization by 2008, number of PSA tests, and frequency of prostate biopsy were similar across frequency categories. In multivariable analyses, the hazard ratio for PCa incidence for ≥21 compared to 4–7 ejaculations per month was 0.81 (95% confidence interval [CI] 0.72–0.92; p < 0.0001 for trend) for frequency at age 20–29 yr and 0.78 (95% CI 0.69–0.89; p < 0.0001 for trend) for frequency at age 40–49 yr. Associations were driven by low-risk disease, were similar when restricted to a PSA-screened cohort, and were unlikely to be explained by competing causes of death. Conclusions These findings provide additional evidence of a beneficial role of more frequent ejaculation throughout adult life in the etiology of PCa, particularly for low-risk disease. Patient summary We evaluated whether ejaculation frequency throughout adulthood is related to prostate cancer risk in a large US-based study. We found that men reporting higher compared to lower ejaculatory frequency in adulthood were less likely to be subsequently diagnosed with prostate cancer. Take Home Message [B]In a large prospective study with long-term follow-up, men who reported more frequent ejaculation in adulthood had a lower risk of total incidence of prostate cancer. Ejaculation frequency represents a potentially modifiable risk factor for prostate cancer.[/B] Keywords: Epidemiology, Ejaculation, Behavioral risk factors. Footnotes a Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA b Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA c Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA d Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA e Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA [/QUOTE]
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Ejaculation Frequency and Risk of Prostate Cancer: Updated Results after a Decade
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