Erectile Dysfunction Medications and Skin Cancer: An Analysis in US Veterans

Christie, A. B.; Vera, Pedro L.; Higgins, Margaret; Kumar, Sandeep; Lane, Matthew; Preston, David

doi:10.1016/j.urology.2019.01.025

Cited by 3 publications

(5 citation statements)

References 15 publications

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“…In the remaining 21 records, 13 of the records were excluded because they were small in study samples, not published in English, or did not have sufficient information for outcome measurements. After screening for the form of data reporting, 8 observational studies [ 15 16 17 18 19 20 21 22 ] (7,479,852 patients) were pooled in the final metaanalysis ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The main features of the 8 studies are presented in Table 1 . Six cohort studies [ 15 16 17 19 21 22 ] and 2 case-control studies [ 18 20 ] involving 7,479,852 patients were included in the meta-analysis. Two studies might have overlapping subjects because they were conducted by using the same database [ 17 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…Stages of MM were divided into in situ , localized (N 0 and M 0 ), and non-localized (N 1 or M 1 ). Among the 8 studies, only 5 of them mentioned comorbidities [ 17 18 19 20 22 ], 2 reported associated cancers [ 18 20 ], and 6 referred to confounding factors [ 15 17 18 19 20 21 ]. Although some of the studies adjusted the duration of PDE5Is use in multivariable analysis, unlike doses of PDE5Is, none of them showed available information on this that could be stratified.…”

Section: Resultsmentioning

confidence: 99%

“…It is unknown whether PDE5Is could increase the risk of BCC or SCC in a molecular or cellular level. Additionally, studies by Loeb et al [ 18 ] and Christie et al [ 21 ] indicated that PDE5Is users usually had higher educational status and annual incomes and the two factors were significantly related to the risk of developing MM. Furthermore, Pottegård et al [ 20 ] showed that PDE5Is users tended to have lower stage or grade of MM than nonusers, suggesting that more medical seeking behaviors might contribute to the slightly increased risk of developing MM by resulting in earlier detection.…”

Section: Discussionmentioning

confidence: 99%

“…After their research, there were only 5 other published observational studies between 2014–2017 [ 16 17 18 19 20 ]. In 2018 and 2019, two studies including 5,945,237 subjects were conducted to examine the associations between PDE5Is use and the risk of skin cancers in the USA [ 21 22 ]. For the inconsistencies existed among these studies, it is impossible to identify the relationship between PDE5Is and the risk for the development of skin cancers.…”

Section: Introductionmentioning

confidence: 99%

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Phosphodiesterase Type 5 Inhibitors and Risk of Skin Cancers in Men: A Meta-Analysis and Trial Sequential Analysis Involving 7,479,852 Subjects

Lü

Fan

Liang

et al. 2021

World J Mens Health

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We conducted a systematic review and meta-analysis to quantify the association between phosphodiesterase type 5 inhibitors (PDE5Is) use and skin cancers and we also examined whether down-expression of the PDE5A gene was related to worse prognosis for malignant melanoma (MM) patients. Materials and Methods: Materials and Methods: The PubMed, Cochrane Library, Web of Science, EMBASE, and ClinicalTrails.gov databases were searched. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the association between PDE5Is use and risk of skin cancers. Cumulative meta-analysis and trial sequential analysis (TSA) were also conducted. Survival outcomes were analyzed online. Results: Results: After pooling all 8 eligible studies comprising 7,479,852 subjects, we found that PDE5Is use was significantly associated with slightly increased risk of developing MM (OR: 1.13, 95% CI: 1.05 to 1.21, I 2 =67.1%), basal cell carcinoma (OR: 1.16, 95% CI: 1.13 to 1.19, I 2 =49.6%), and squamous cell carcinoma (OR: 1.07, 95% CI: 1.01 to 1.13, I 2 =0.0%). Totally, PDE5Is increased the risk of developing skin cancers (OR: 1.13, 95% CI: 1.09 to 1.17, I 2 =70.8%). TSA results showed that the sample size was enough to reach a positive conclusion. Conclusions: Conclusions: The use of PDE5Is may be slightly associated with increased risk of developing skin cancers. There should be a balance between drug benefits and potential safety issues. However, the pooled results should be considered tentative until confounding factors such as sun exposure and lifestyle are well-controlled in further studies.

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