Men who took sildenafil demonstrated an increased risk for melanoma. The association was significant among men who reported recent sildenafil use at baseline, although researchers also observed an association among those who reported ever use.
“Our results should be interpreted cautiously and are insufficient to alter current clinical recommendations,” Wen-Qing Li, PhD, from the department of dermatology at Brigham and Women's Hospital, and colleagues wrote. “Nevertheless, our data provide epidemiological evidence on possible skin adverse effects of PDE5A inhibitors and support continued investigation of this relationship.”
The use of sildenafil citrate (Viagra, Pfizer), a phosphodiesterase (PDE) 5A inhibitor commonly used for erectile dysfunction, has been shown to increase the invasiveness of melanoma cells.
Researchers evaluated the association between the use of sildenafil and the subsequent risk for melanoma among 25,848 men included in the Health Professionals’ Follow-up Study.
The participants reported incidence of melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) via questionnaires administered biennially. Melanoma and SCC diagnoses were pathologically confirmed.
Between 2000 and 2010, researchers identified 142 melanomas, 580 SCCs and 3,030 BCCs among study participants.
Results showed ever use of sildenafil was associated with a higher risk for melanoma (HR=1.92; 95% CI, 1.14-3.22). Researchers also determined recent sildenafil use at baseline was significantly associated with increased melanoma risk (multivariate-adjusted HR=1.84; 95% CI, 1.14-3.22).
Researchers did not observe an association between sildenafil use and risk for SCC (HR=0.84; 95% CI, 0.59-1.20) or BCC (HR=1.08; 95% CI, 0.93-1.25).
Results of a secondary analysis that excluded men with major chronic diseases at baseline did not significantly alter findings, as the HR for melanoma among those who reported sildenafil use at baseline was 2.24 (95% CI, 1.05-4.78) and the HR among those who reported ever use of sildenafil was 2.77 (95% CI, 1.32-5.85).
The researchers noted that erectile function itself was not associated with altered risk for melanoma.
Disclosure: The researchers report no relevant disclosures.