Several case-control studies have addressed the possibility that sexual factors play a role in prostate cancer etiology (see [13,32-34,111-113]). In general, the results of these studies suggest that prostate cancer risk may be associated with (1) an early onset of sexual activity, (2) high sexual drive, particularly at young age, (3) a low frequency of intercourse, especially at older age, or (4) a high frequency of intercourse up to 50 years of age and a low frequency thereafter (see ). A positive association has been reported between the level of sexual activity and circulating total testosterone levels in men of 60-79 . These findings suggest that a hormonal mechanism may underlie the associations between prostate cancer risk and sexual activity observed in the case-control studies.
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