SEPTEMBER is observed as Prostate Cancer Awareness Month, and I have often wondered about the relationship between promiscuity and prostate cancer, juxtaposed with the belief that frequent ejaculation may be protective against the disease. One interesting question emerging from my musings is: Could frequent sexual activity and, more specifically, frequent ejaculation reduce a man’s risk of developing prostate cancer, and, if so, does having multiple sexual partners offer the same benefit?

Demystifying this issue is important because there is a critical distinction. Scientific evidence increasingly suggests that ejaculation frequency may have some significance, while there is no evidence that having multiple sexual partners protects the prostate gland. In fact, multiple sexual partnerships may introduce additional risks with potentially serious health consequences.

Prostate cancer is a major threat to Caribbean men

The importance of prostate cancer among men in Jamaica and the wider Caribbean cannot be overstated. According to the Global Cancer Observatory, approximately 1.47 million men were diagnosed with prostate cancer worldwide in 2022, and about 397,000 died from the disease. Prostate cancer is the second most commonly diagnosed cancer and the fifth-leading cause of cancer death among men globally, although estimates may vary depending on the source.

The Caribbean carries a disproportionately heavy burden. International Agency for Research on Cancer (IARC) estimates indicate that approximately 22,271 Caribbean men developed prostate cancer in 2022, accounting for 35.1 per cent of all new cancers among Caribbean males. Approximately 9,695 Caribbean men died from the disease, with an age-standardised mortality rate of approximately 26.4 per 100,000 men among the highest regional rates internationally.

The statistics for Jamaica are even more sobering. IARC estimated 1,599 new prostate cancer cases in Jamaica in 2022, representing 43.1 per cent of all cancers diagnosed among Jamaican men. Prostate cancer was also the country’s leading cause of male cancer death.

These figures make conversations about prostate cancer prevention, early detection and men’s sexual health far more than interesting dinner-table discussions. They are public health conversations that Jamaica needs to have now. In my November 6, 2022
Jamaica Observer article, ‘Men Need Not Dread the Digital Rectal Examination
(DRE)’, I highlighted the need for more work to positively influence men’s attitudes towards accepting the DRE. Appropriate screening and early detection can facilitate timely diagnosis and treatment, thereby reducing morbidity and potentially improving survival and quality of life.

So, does frequent sex protect the prostate?

Perhaps, but the relationship between sexual activity and prostate health requires careful interpretation. Researchers have not established that frequent sex prevents prostate cancer. Nevertheless, some studies have identified an association between ejaculation frequency and a lower incidence of the disease.

Michael Leitzmann and colleagues, in a landmark study involving 29,342 United States men, found that higher ejaculation frequency was not associated with increased prostate cancer risk. In some groups, men reporting 21 or more ejaculations per month experienced lower prostate cancer risk compared with those reporting four to seven ejaculations monthly.

Jennifer Rider and colleagues subsequently strengthened these findings. Men aged 20-29 who reported at least 21 ejaculations monthly had approximately a 19 per cent lower incidence of prostate cancer than those reporting four to seven ejaculations per month. Among men aged 40-49, the difference was approximately 22 per cent. The association appeared particularly evident for lower-risk prostate cancer.

While this may sound like an excellent prescription, the findings require context. These are observational studies demonstrating association, not causation. Men who ejaculate frequently may differ from other men in physical activity, diet, relationships, health status and other behaviours that could influence cancer risk.

Importantly, the research measured ejaculation not sexual intercourse. Ejaculation may occur through partnered sexual activity or masturbation. In other words, the scientific message is certainly not: “Have more partners to save your prostate.”

Next week: More ejaculation does not mean more partners

Professor Adella Campbell is a lecturer in the College of Health Sciences, University of Technology, Jamaica.

Prof Adella Campbell.