No association between use of phosphodiesterase 5 inhibitors and colorectal cancer in men with erectile dysfunction.

Purpose: There is an increase interest on the potential chemoprotective effect of selective phosphodiesterase 5 (PDE5) inhibitors. Several authors have shown in vivo the immune-mediated anti-tumor effect of these inhibitors on tumors arising from the digestive tract.
Objectives: To test the potential effect of selective PDE5 inhibitors against colorectal cancer (CRC) onset previously observed.
Methods: We used data from The Health Improvement Network database and identified an established cohort of 200 000 new users of low-dose aspirin and a matched comparison cohort aged 40-84 years between 1 January 2000 and 31 December 2011. A follow-up to identify CRC cases was performed within an extensive validation exercise. Nested case-control analyses compared PDE5 inhibitors vs non-use on CRC risk were performed.
Results: Restricting to males (59.3% controls and 59.5% cases), no association was observed among current users of PDE5 inhibitors (1.05 [95% CI: 0.69-1.60]) and neither among recent (1.36 [95% CI: 0.81-2.28]) or past users (1.06 [95% CI: 0.72-1.58]). No duration response effect was found.
Conclusions: Our results do not support an increased risk of CRC associated with the use of PDE5 inhibitors among men with erectile dysfunction.
(© 2020 John Wiley & Sons Ltd.)