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Meta-Analysis
. 2025 Dec 4;26(1):47.
doi: 10.1186/s12885-025-15410-3.

Updated dose-response meta-analysis of sexual activity and prostate cancer risk

Abouzar Raeisvandi  1 , Sanaz Omidi  1 , Massoumeh Javaheri  1 , Hanieh Moradi  2 , Jalal Poorolajal  3   4   5
Affiliations
Meta-Analysis

Updated dose-response meta-analysis of sexual activity and prostate cancer risk

Abouzar Raeisvandi et al. BMC Cancer. .

Abstract

Background: This systematic review and meta-analysis aimed to update the evidence on how sexual activity factors, including frequency of intercourse, number of female sexual partners, age at first intercourse, and number of ejaculations and masturbations relate to prostate cancer.

Methods: We conducted a comprehensive search across PubMed, Web of Science, and Scopus up to October 19, 2025. We also reviewed existing study references for additional relevant research. To assess study consistency, we used I2 statistics. Publication bias was evaluated using Begg and Egger tests. Our analysis reported pooled odds ratios (OR) with 95% confidence intervals using a random-effects model. The research protocol was approved by PROSPERO, ID CRD42024549018.

Results: From 5,311 identified studies, 29 (315,193 participants) met the inclusion criteria. Positive but non-significant associations were observed between prostate cancer and more frequent sexual intercourse (OR = 1.02; 95% CI: 0.88, 1.18), a higher number of female partners (OR = 1.01; 95% CI: 0.90, 1.12), and masturbation frequency (OR = 1.12; 95% CI: 0.82, 1.54). Older age at first intercourse showed a negative but non-significant association (OR = 0.99; 95% CI: 0.90, 1.08), whereas higher ejaculation frequency demonstrated a significant protective effect (OR = 0.83; 95% CI: 0.77, 0.90).

Conclusion: These findings suggest that most sexual behaviors are not significantly associated with prostate cancer risk. However, higher ejaculation frequency appears to have a protective effect. The results highlight the multifactorial nature of prostate cancer and emphasize the need for further research to clarify the role of sexual activity in disease prevention.

Keywords: Intercourse; Meta-analysis; Prostate cancer; Sexual activity; Sexual partners.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow of information through the various phases of the systematic review
Fig. 2
Fig. 2
Association between the number of sexual intercourses per week and prostate cancer: a Forest plot; b Linear dose–response curve (Solid line: pooled odds ratio; dashed lines: 95% confidence intervals)
Fig. 3
Fig. 3
Association between the number of female sexual partners and prostate cancer: a Forest plot; b Linear dose–response curve (Solid line: pooled odds ratio; dashed lines: 95% confidence intervals)
Fig. 4
Fig. 4
Association between age at first intercourse and prostate cancer: (a) Forest plot; (b) Linear dose–response curve (Solid line: pooled odds ratio; dashed lines: 95% confidence intervals)
Fig. 5
Fig. 5
Association between number of ejaculations and prostate cancer: a Forest plot; b Linear dose–response curve (Solid line: pooled odds ratio; dashed lines: 95% confidence intervals)
Fig. 6
Fig. 6
Forest plot showing the association between the number of masturbations and prostate cancer
See this image and copyright information in PMC

References

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