August 30, 2019

Men's health research

Kaiser Permanente research scientists have published more than 300 articles related to men’s health since 2007. These articles have been cited over 8,000 times.

This brief summarizes the contributions of Kaiser Permanente Research since 2007 on the topic of men’s health. Although men’s health encompasses a wide range of health issues, this brief will focus on specific conditions affecting men (such as prostate cancer, testicular cancer, benign prostatic hyperplasia, and erectile dysfunction), as well as certain conditions for which men have specific or elevated risks (such as infertility, hypogonadism, bladder cancer, cardiovascular disease, back pain, and opioid use disorders).

Men in the United States are at risk for a variety of acute and chronic health problems. Approximately 1 in 9 will be diagnosed with prostate cancer at some point, making it the second-most common cancer among American men. The American Cancer Society estimates that over 30,000 men will die of this disease in 2019.1 Testicular cancer is less common than prostate cancer, affecting 1 in every 250 males, but it typically affects much younger men and boys, with an average age at diagnosis of just 33.1 In addition, more than three-quarters of the 80,000 Americans who will be diagnosed with bladder cancer this year are men, and nearly 13,000 men are expected to die from this cancer in 2019.1 Men are also more likely to suffer from common chronic illnesses. Cardiovascular disease causes 1 of every 4 deaths in men, and a large majority of sudden cardiac events occur in men.2 Furthermore, men are more likely to be diagnosed with opioid use disorders.3

Many of the health problems men face can significantly affect their quality of life. Benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland often leading to urinary symptoms, is a very common condition, affecting more than 14 million men.4 Erectile dysfunction (ED) also affects approximately 20% of men, and becomes more common with age: one study estimated that ED is experienced by 5% of men under 40, but 70% of men 70 and older.5 ED often occurs in men with low testosterone, or hypogonadism, which is estimated to affect 6% of Americans.6,7 Infertility is an issue for 1 in 6 couples in the United States, and male infertility is implicated in two-thirds of all cases.8 Moreover, while low back pain is more common in women,9 men are much more likely to be prevented from working by this pain.10

 

Publications related to men’s health since 2007

340 Journal Articles, 8,200 Citations (1), 12 Practice Guideline References (b), 18 Clinical Decision Aid References (c)

Source: Kaiser Permanente Publications Library and PLUM metrics, as of April 15, 2019.

a. Number of citing journal articles, according to Scopus.
b. Number of references in PubMed guidelines.
c. Citations in DynaMed Plus, a point-of-care clinical reference tool.

Men’s health is an active area of study for Kaiser Permanente Research. Scientists across the program have used our rich, comprehensive, longitudinal data to advance knowledge in the areas of understanding risk, improving patient outcomes, and translating research findings into policy and practice. We have published more than 300 articles related to men’s health since 2007;11 together, these articles have been cited over 8,000 times. These articles are the product of observational studies, randomized controlled trials, meta-analyses, and other studies led by Kaiser Permanente scientists. Our unique environment — a fully integrated care and coverage model in which our research scientists, clinicians, medical groups, and health plan leaders collaborate — lets us contribute generalizable knowledge on men’s health, and many other topics of research. 

 


References

  1. American Cancer Society. Cancer Facts & Figures, 2019. Atlanta, GA: American Cancer Society;2019.
  2. Centers for Disease Control and Prevention. Men and Heart Disease Fact Sheet. 2017; https://www.cdc.gov/dhdsp/data_statistics/fact_ sheets/fs_men_heart.htm. Accessed April 15, 2019.
  3. Center for Behavioral Health Statistics and Quality. 2016 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration;2017.
  4. National Institute of Diabetes and Digestive and Kidney Diseases. Prostate Enlargement (Benign Prostatic Hyperplasia). 2014; https://www. niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostate-enlargement-benign-prostatic-hyperplasia. Accessed April 15, 2019.
  5. Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007;120(2):151-157.
  6. Araujo AB, Esche GR, Kupelian V, et al. Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab. 2007;92(11):4241-4247.
  7. Araujo AB, O’Donnell AB, Brambilla DJ, et al. Prevalence and incidence of androgen deficiency in middle-aged and older men: estimates from the Massachusetts Male Aging Study. J Clin Endocrinol Metab. 2004;89(12):5920-5926.
  8. American Society for Reproductive Medicine. Defining Infertility. Birmingham, AL: American Society for Reproductive Medicine;2014.
  9. Shmagel A, Foley R, Ibrahim H. Epidemiology of Chronic Low Back Pain in US Adults: Data From the 2009-2010 National Health and Nutrition Examination Survey. Arthritis Care Res (Hoboken). 2016;68(11):1688-1694.
  10. Centers for Disease Control and Prevention. A NIOSH Look at Data from the Bureau of Labor Statistics: Worker Health by Industry and Occupation. Cincinnati, OH: National Institute for Occupational Safety and Health;2001.
  11. KPPL Search, conducted on April 15, 2019: ((dc.subject.mesh:”prostatic neoplasms” OR dc.subject.mesh:”prostate hyperplasia” OR dc.subject.mesh:”prostatism” OR dc.subject.mesh:”Prostatic Diseases” OR dc.subject.mesh:”testicular neoplasms” OR dc.subject. mesh:”scrotum” OR dc.subject.mesh:”testis” OR dc.subject.mesh:”men’s health” OR dc.subject.mesh:”erectile dysfunction” OR dc.subject. mesh:”impotence, vasculogenic” OR dc.subject.mesh:”penile erection” OR dc.subject.mesh:”penis” OR dc.subject.mesh:”infertility, male” OR dc.subject.mesh:”semen” OR dc.subject.mesh:”vasectomy” OR dc.subject.mesh:”Epididymitis” OR dc.subject.mesh:”Penile Diseases” OR dc.subject.mesh:”Spermatic Cord Torsion” OR dc.subject.mesh:”Cryptorchidism” OR dc.subject.mesh:”Orchitis” ) OR (title:”prostate cancer”~4 OR title:”prostatectomy” OR title:”androgen deprivation therapy” OR title:”prostate antigen”~3 OR title:”prostate carcinoma”~4 OR title:”prostatic enlargement” OR title:”prostatic hyperplasia” OR title:”prostatitis” OR title:”Sildenafil “ OR title:”testicular cancer”~4 OR title:”testicular tumors”~4 OR title:”testicular seminoma” OR title:”neoplasia testis” OR title:”paratesticular adenomatoid tumor” OR title:”erectile dysfunction” OR abstract:”erectile dysfunction” OR title:”peyronie’s disease” OR title:”vasectomy” OR title:”circumcision”) OR ((title:men OR title:male) NOT (title:women OR title:female)) OR (citation:”Am J Mens Health” OR citation:”Harv Mens Health Watch” OR citation:”J Mens Health” )) AND dc.type:”Journal Article” AND dc.date.issued:[2007 2019].
  12. Kaulfuss S, Grzmil M, Hemmerlein B, et al. Leupaxin, a novel coactivator of the androgen receptor, is expressed in prostate cancer and plays a role in adhesion and invasion of prostate carcinoma cells. Mol Endocrinol. 2008;22(7):1606-1621.
  13. Travis RC, Schumacher F, Hirschhorn JN, et al. CYP19A1 genetic variation in relation to prostate cancer risk and circulating sex hormone concentrations in men from the Breast and Prostate Cancer Cohort Consortium. Cancer Epidemiol Biomarkers Prev. 2009;18(10):2734- 2744.
  14. Yeager M, Chatterjee N, Ciampa J, et al. Identification of a new prostate cancer susceptibility locus on chromosome 8q24. Nat Genet. 2009;41(10):1055-1057. 
  15. Lou H, Yeager M, Li H, et al. Fine mapping and functional analysis of a common variant in MSMB on chromosome 10q11.2 associated with prostate cancer susceptibility. Proc Natl Acad Sci U S A. 2009;106(19):7933-7938.
  16. Koutros S, Schumacher FR, Hayes RB, et al. Pooled analysis of phosphatidylinositol 3-kinase pathway variants and risk of prostate cancer. Cancer Res. 2010;70(6):2389-2396.
  17. Schumacher FR, Cheng I, Freedman ML, et al. A comprehensive analysis of common IGF1, IGFBP1 and IGFBP3 genetic variation with prospective IGF-I and IGFBP-3 blood levels and prostate cancer risk among Caucasians. Hum Mol Genet. 2010;19(15):3089-3101.