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Viagra can give men with erectile dysfunction a boost in their sex lives, but can it also increase their risk of melanoma, the deadliest form of skin cancer? No, says an analysis of five large studies which included 866,049 men.

Scientists have long speculated that Viagra increases the risk of skin cancer. Some previous studies indicated that the active drug in Viagra — sildenafil — stimulates a molecule that causes existing tumors to grow.

But  while investigators at NYU Langone Medical Center and its Perlmutter Cancer Center found an overall 11 percent increase in the risk of developing skin cancer among men using Viagra, they found no evidence that the medicines cause melanona.

Instead, they attribute the risk to “detection bias,” where the group of patients likely to take erection medicines also happens to be more health conscious, more likely to see a doctor, and so more likely to get diagnosed with melanoma than other men of similar age.

The researchers found an overall increase in melanoma risk among men who use Viagra and other erectile dysfunction drugs collectively known as phosphodiesterase type 5 (PDE5) inhibitors, but they hypothesized that if a cause and effect exists, higher use of erection medications would be associated with higher risk of developing the disease.

However, urologist Stacy Loeb and her colleagues found the opposite: There was an increase in risk among men who had a small amount of exposure to these medications, and men who took larger amounts of erectile dysfunction medications had no significant increase in melanoma risk.

The researchers also theorized that if erectile dysfunction medications cause melanoma, they would find more aggressive disease among people who take the medications. Instead, they found an increased risk of early stage melanoma among erection medicine users, but those who took such medications were at a lower risk for aggressive melanoma than non-users.

“Overall, Viagra and other PDE5 inhibitors are safe medications as long as men are not taking nitrates, which carry a risk of reducing blood pressure,” Loeb said. “Physicians and patients should not be concerned about taking these medications on account of worry about melanoma.”

“Physicians should still screen for melanoma risk, but they do not need to add the use of Viagra and similar drugs to the list of screening criteria specifically,” says Stacy Loeb. “In general, men should continue to be careful about the risk of any kind of skin cancer from excessive sun exposure and use sun protection.”

The study was published in the Journal of the National Cancer Institute.

The Massachusetts Male Aging Study estimated that about 50 million American men struggle with erectile dysfunction at some point in their lives.