Sex with Animals (SWA): Behavioral Characteristics and Possible Association with Penile Cancer. A Multicenter Study

Abstract

Introduction Zoophilia has been known for a long time but, underreported in the medical literature, is likely a risk factor for human urological diseases. Aim To investigate the behavioral characteristics of sex with animals (SWA) and its associations with penile cancer (PC) in a case-control study. Methods A questionnaire about personal and sexual habits was completed in interviews of 118 PC patients and 374 controls (healthy men) recruited between 2009 and 2010 from 16 urology and oncology centers. Main Outcome Measures SWA rates, geographic distribution, duration, frequency, animals involved, and behavioral habits were investigated and used to estimate the odds of SWA as a PC risk factor. Results SWA was reported by 171 (34.8%) subjects, 44.9% of PC patients and 31.6% of controls (P < 0.008). The mean ages at first and last SWA episode were 13.5 years (standard deviation [SD] 4.4 years) and 17.1 years (SD 5.3 years), respectively. Subjects who reported SWA also reported more venereal diseases (P < 0.001) and sex with prostitutes (P < 0.001), and were more likely to have had more than 10 lifetime sexual partners (P < 0.001) than those who did not report SWA. SWA with a group of men was reported by 29.8% of subjects and SWA alone was reported by 70.2%. Several animals were used by 62% of subjects, and 38% always used the same animal. The frequency of SWA included single (14%), weekly or more (39.5%), and monthly episodes (15%). Univariate analysis identified phimosis, penile premalignancies, smoking, nonwhite race, sex with prostitutes, and SWA as PC risk factors. Phimosis, premalignant lesions, smoking, and SWA remained as risk factors in multivariate analysis. However, SWA did not impact the clinicopathological outcomes of PC. Conclusion SWA is a risk factor for PC and may be associated with venereal diseases. New studies are required in other populations to test other possible nosological links with SWA.

Penile cancer: impact of age at diagnosis on morphology and prognosis

“…The current literature and proposed prognostic indexes do not include age at cancer diagnosis as important information of prognostic value [18][19][20][21]. Recently, a multicenter study reported that zoophilia (sex with animals) was an independent factor for penile cancer, even though it did not impact on prognosis [22]. Although it is believed that zoophilia is common in Brazil, our medical records had no information on this behavior and precluded the evaluation on how patients from distinct age groups differed on this issue.…”

Profile of patients with penile cancer in the region with the highest worldwide incidence

“…The relationship between zoophilia and penile cancer was the subject of a recent study 42 . The authors consider zoophilia a risk factor and demonstrate that men who practiced sex with animals are two times more likely to develop cancer of the penis.…”

Kurthia gibsonii as a sexually transmitted zoonosis: From a neglected condition during World War II to a recent warning for sexually transmitted disease units

“…Subjects who report SWA also report more venereal diseases. [1] In our laboratories, all procedures were carried out manually; consequently, discordant biochemical results were noticed early. Using automated diagnostic tools not programed for animal or environmental microbes, such pathogens could be misinterpreted.…”

“…Its designation (recently: Sex with animals [SWA]), range of animal species, and acceptance by the public have been varied depending on historical times, geographical locations, demographic characteristics, and related sexual behaviors. [1] Direct contact of genital organs between humans and animals predisposes to mutual transmission of microbes being present either as members of the normal flora or pathogens. However, data on zoophilic sexual transmission of nonhuman pathogens are scarcely available in the literature.…”