Asian and Hispanic men are less likely to receive treatment for erectile dysfunction

Asian and Hispanic men are less likely to receive treatment for erectile dysfunction (ED), according to a study presented at the 2021 American Urological Association annual meeting.¹

Tony Chen, MD

“Asian men had the lowest rates of ED treatments compared to Caucasian men, regardless of modality of treatment. African American men had the highest rates of receiving ED treatment regardless of modality of treatment. Hispanics had a lower rate of receiving any treatment, but when they did, they tended to receive surgery more often than Caucasian men. These results were after matching for clinical and sociodemographic factors,” said author Tony Chen, MD, clinical assistant professor in the department of urology at Stanford University, California.

The study used Optum’s De-identified Clinformatics Data Mart database to examine the racial differences in therapeutic preferences for ED treatment. A retrospective review was conducted using administrative diagnosis, procedural, and pharmacy codes. SAS software analyses compared the population’s race (Caucasian, African American, Hispanic, Asian, other), socioeconomic variables (age, education level, income level) and comorbidities (smoking status, HTN, HLD, DM2).

Primary outcomes were types and patterns of ED therapies, including oral agents, intraurethral agents, intracavernosal injection, vacuum erection device, and surgery.

Patients with diagnoses of ED between 2003 and 2018 who were over the age of 18 were selected for this study. Men with less than 1 year of enrollment before or after ED diagnosis were excluded as well as men with a history of prostate cancer.

A total of 810,916 men met the inclusion criteria. Of the men, 74.9% were Caucasian, 10.5% were African American, 11.5% were Hispanic, and 3.1% were Asian. At a median follow-up of 3.8 years, results showed that Asian patients were the least populous group (26,633), tended to be slightly younger compared to patients of other races (mean = 52.6), had higher education degrees (39.3% with a bachelor’s degree or plus) and had higher incomes (44.3% greater than $100,000).

The investigators found that 34.6% of Caucasian men, 36.4% of African American men, 29% of Hispanic men, and 30.8% of Asian men underwent any ED treatment and 0.27% of Caucasian men, 0.44% of African American men, 0.21% of Asian men, and 0.4% of Hispanic men underwent surgery for ED.

Even after matching age, comorbidity, socioeconomic status, and urologist visit frequency with Caucasian men, Asian and Hispanic men were less likely to receive treatment than Caucasian and African American men.

Chen noted some limitations to the research, including the fact that the claims data were unable to account for out-of-pocket therapies, men with employer-based insurance may not be widely generalizable, and racial categories’ lack of granular data such as ethnicity, citizenship status, country of birth, and generational status within the US.

“In conclusion, there exist significant racial differences in ED treatment seeking patterns. These differences are likely the result of complex interactions between socioeconomic, cultural, medical, and lifestyle factors. For Asian and Hispanic men who are less likely to receive ED treatments, future studies may identify potential barriers to ED care and to seek improved access for those populations,” Chen concluded.

Reference

1. Chen T, Li S, Eisenberg M. Association between race and erectile dysfunction treatment patterns. Paper presented at 2021 American Urological Association Annual Meeting; September 10-13; virtual. Abstract LBA01-0