Hematospermia does not increase the risk of prostate cancer detection in prostate biopsy

Studies on the association between hemospermia and prostate cancer are insufficient. The purpose of this study was to determine prevalence of prostate cancer in patients with hematospermia using a large United States population data. This was a retrospective observational cohort study. Administrative claims data were extracted from the IBM® MarketScan Research Database. Patients who had undergone prostate biopsy and newly diagnosed patients with hematospermia before prostate biopsy from January 2007 to December 2014 were included using International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) codes. Treatment methods were identified with Current Procedural Terminology (CPT) code. A total of 36,9170 adult men had prostate biopsy. Mean age of patients was 62 years (range, 18 to 100 years). Among the TRUS bx patients, the number of patients with hematospermia was 1,357 (0.4%). Prostate cancer detection rate was significantly lower in patients with hematospermia than in patients without hematospermia (30.4% vs. 48.0%, p< 0.01). During the study period, 83,712 patients had hematospermia, of whom only 1.6% underwent prostate biopsy. Only 1.6% of hematospermia patients underwent prostate biopsy. Prostate cancer was detected at a lower rate in those with hematospermia than in those without hematospermia. This study suggests that presence of hematospermia prior to biopsy does not increase the risk of prostate cancer detection.