LEXINGTON, KY—Is there a relationship between phosphodiesterase 5 inhibitor drugs, prescribed for erectile dysfunction, and skin cancers? A large-scale study of veterans sought to determine that.

A retrospective review using the VAs Informatics and Computing Infrastructure database was recently published in the journal Urology.1

For the study, Lexington, KY, VAMC and University of Kentucky-led researchers searched the database over 19 years to identify veterans who received PDE5i treatment for erectile dysfunction. Veterans who never took the drugs were used for comparison analysis. In both groups, follow-up time, outpatient clinic visits and incidence of malignant melanoma and basal cell carcinoma were measured.

Included were 2.55 million veterans were included in this study, 1.27 million in each group. Mean age of the PDE5i group and non-PDE5i group was 59.2 years (standard deviation [SD] ± 10.8) and 58.7 (SD ± 10.8), respectively. Mean follow-up time for the PDE5i group was 8.9 years (SD ± 4.2) and 8.5 years (SD ± 4.3) for non-PDE5i group.

Results indicated that the odds ratio for malignant melanoma and BCC in the PDE5i group was 1.25 (confidence interval 95%, 1.22-1.28, P <.0001) and 1.49 (confidence interval 95%, 1.46-1.51, P <.0001), respectively. PDE5i users also showed more mean outpatient visits/year (8.9 SD ± 9.50) compared to non-PDE5i users (5.9 SD ± 10.0; P <.0001), the study team noted.

“Veterans prescribed PDE5is to treat erectile dysfunction show a minimal increased risk of MM and a greater risk of BCC compared to non-PDE5i users,” study authors concluded. “PDE5i users visited outpatient VA clinics at a higher rate than non-PDE5i users in this study. These findings suggest confounding variables are likely involved in the relationship between skin cancers and PDE5i use. PDE5i drugs remain a safe treatment for erectile dysfunction.”

1 Christie A, Vera PL, Higgins M, Kumar S, Lane M, Preston D. Erectile Dysfunction Medications and Skin Cancer: An Analysis in US Veterans. Urology. 2019 Apr;126:116-120. doi: 10.1016/j.urology.2019.01.025. Epub 2019 Feb 5. PubMed PMID: 30735744.