Purpose: We performed a cross-cultural comparison of sexual function and bother in men with localized prostate cancer in the United States and Japan.
Materials and methods: A total of 447 Japanese and 427 American men with clinically localized prostate cancer were enrolled in separate studies of health related quality of life outcomes. Sexual function and bother were estimated before treatment with validated English and Japanese versions of the UCLA Prostate Cancer Index.
Results: Japanese men were more likely than American men to report poor sexual desire (OR 21.2, 95% CI 12.2-37.0), poor erection ability (OR 16.2, 95% CI 9.7-27.1), poor overall ability to function sexually (OR 16.7, 95% CI 9.7-28.9), poor ability to attain orgasm (OR 1.7, 95% CI 1.3-2.3), poor quality of erections (OR 2.5, 95% CI 1.9-3.5), infrequency of sexual erections (OR 2.3, 95% CI 1.7-3.1), infrequency of morning erections (OR 2.7, 95% CI 1.8-4.2) and intercourse in the previous 4 weeks (OR 2.7, 95% CI 1.9-3.8). However, Japanese men were less likely than American men to be bothered by sexual function (OR 0.36, 95% CI 0.24-0.54). A small subset of 10 Japanese-American men reported sexual function that more closely resembled their counterparts in Japan than in the United States.
Conclusions: We posit that cultural disparities in completing the quality of life surveys explain the differences in sexual activity profiles in Japanese and American men with prostate cancer.