MP75-05 EFFECT OF SEXUAL BEHAVIOR ON PROSTATE-SPECIFIC ANTIGEN LEVELS IN MIDDLE-AGED MEN SCREENED FOR PROSTATE CANCER

Abstract

INTRODUCTION AND OBJECTIVE: Factors such as prostatitis or benign prostate hyperplasia are known to increase PSA levels. Previous studies have found higher PSA levels after ejaculation, however, knowledge about whether various aspects of sexual behavior lead also to higher PSA levels is lacking. Therefore, the aim of this study was to investigate the effect of sexual behavior on prostate-specific antigen (PSA) levels in middle-aged men screened for prostate cancer. METHODS: PSA levels of 13,607 45-year-old men were analyzed from the ongoing PROBASE trial between 04/2014 and 04//2018. Multiple linear regression was performed on log-transformed PSA levels to determine the effect of various aspects of sexual behavior on PSA levels. RESULTS: Age at first sexual intercourse, number of lifetime sexual partners, self-perceived intravaginal ejaculatory latency time (IELT), anal intercourse, and sexual identity were not associated with alterations in PSA levels. Partnered sexual activity (2-3 times/week: 10% and ≥4 times/week: 13%) and solo-masturbation (2-3 times/week: 5% and ≥4 times/week: 12%) were associated with higher PSA levels, respectively. Due to the additive effect in the multiple model for log-PSA levels, effects could be multiplied. The combination of being sexually active ≥4 times/week and masturbating ≥4 times/week simultaneously was associated with a higher PSA level of 27%. CONCLUSIONS: Higher frequency of masturbation and sexual activity are associated with higher PSA levels in middle-aged men and, consequently, these men are at increased risk of unnecessary biopsies. Therefore, when their first PSA test passes slightly the biopsy threshold, they should abstain from ejaculation for 48 hours prior to the confirmation PSA test. In contrast, factors such as anal intercourse, sexual identity or number of lifetime sexual partners are not associated with alterations in PSA levels and should be ignored when interpreting a PSA level. These patients should rather be reassured to undergo a prostate biopsy in case of an elevated PSA level. Source of Funding: German Cancer Aid