Prevalence of erectile dysfunction in male survivors of cancer: a systematic review and meta-analysis of cross-sectional studies.

Prevalence of erectile dysfunction (ED) in male survivors of cancer across cancer types has not been systematically analysed.

To estimate the prevalence of ED in all types of cancer and identify characteristics associated with ED in survivors of cancer.

Systematic review and meta-analysis (MA) of cross-sectional studies.

MEDLINE, CINAHL, PsycINFO, and EMBASE were searched, targeting reports published from inception to 1 February 2020. All retrospective or prospective studies reporting prevalence of ED in male patients with cancer and using a validated tool for detection of ED were included. A random-effects MA model was used to pool prevalence of ED as absolute estimates at three different stages, that is, 'healthy', 'at diagnosis', and 'after treatment'. A univariate MA regression including the three-level group variable as the only independent variable was used to assess the difference in ED prevalence across the three groups. Further MAs were conducted for studies involving patients at diagnosis and after treatment, and statistical inferences were made with setting for multiple testing controlling for a false discovery rate (FDR) <0.05.

In total, 1301 studies were assessed for inclusion. Of these, 141 were potentially eligible and subsequently scrutinised in full text. Finally, 43 studies were included with a total of 13 148 participants. Overall, pooled data of the included studies showed an ED prevalence of 40.72% (95% confidence interval [CI] = 31.80 to 50.29) in patients with cancer, with prevalences of 28.60% (95% CI = 12.10 to 53.83) at time of diagnosis and 42.70% (95% CI = 32.97 to 53.03) after treatment, with significant difference between these two stages and across cancer locations, controlling for an FDR <0.05.

Erectile dysfunction was particularly high in male survivors of cancer and was associated with cancer treatment, cancer site, and age.

The British journal of general practice : the journal of the Royal College of General Practitioners. 2021 Apr 29*** epublish ***

Damiano Pizzol, Tao Xiao, Lee Smith, Guillermo F López Sánchez, Andrea Garolla, Christopher Parris, Yvonne Barnett, Petre Cristian Ilie, Pinar Soysal, Jae Il Shin, Mark A Tully, Lin Yang, Nicola Veronese, Igor Grabovac

Italian Agency for Development Cooperation, Khartoum, Sudan., College of Mathematics and Statistics, Shenzhen University, Shenzhen, China., Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK., Faculty of Sport Sciences, University of Murcia, Spain., Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy., Biomedical Research Group, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK., Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, UK., Department of Geriatric Medicine, Bezmialem Vakif University, Istanbul, Turkey., Department of Paediatrics, Yonsei University College of Medicine, Seoul, Korea., School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey, Northern Ireland., Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Holy Cross Centre, Canada., Neuroscience Institute, Aging Branch, National Research Council, Padua, Italy., Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.