Vasectomy is the most frequently used form of male contraception in the United States, with approximately 500,000 procedures performed annually.1 However, several case-control and cohort studies conducted over the past decade have demonstrated conflicting results regarding the possible association between vasectomy and prostate cancer risk.2–5 This has raised considerable concern, not only among men undergoing vasectomy but also among urologists performing the procedure. Many urologists now screen for prostate cancer early in men who have had a vasectomy and even discourage vasectomy in men with a strong family history of prostate cancer.6
The following study further investigated the possible association between vasectomy and prostate cancer in New Zealand, which has the highest prevalence of vasectomy in the world.7
Vasectomy and Risk of Prostate Cancer
Cox B, Sneyd MJ, Paul C, et al.
JAMA. 2002;287:3110–3115.
The authors conducted a national population-based case-control study of 923 new cases of prostate cancer among men aged 40 to 74 years from the New Zealand Cancer Registry who were on the general electoral roll. The control group (n = 1224) was randomly selected from the general electoral roll and matched in 5-year age groups. The primary study outcome was the relative risk (RR) of prostate cancer for men who had vasectomies compared with controls. Mean ages for the cases and controls were 66 and 65 years, respectively. All cases and controls were contacted via telephone by interviewers who were blinded to the subject group and who collected information regarding previous illnesses, urologic symptoms and surgical procedures, smoking and alcohol consumption, prostate-specific antigen testing, digital rectal examination, family history of cancer, sociodemographic characteristics, and history of vasectomy. Results demonstrated no association between prostate cancer and vasectomy (RR, 0.92; 95% confidence interval [CI], 0.71–1.14) or time since vasectomy (RR, 0.92; 95% CI, 0.68-1.23 for ≥25 years since vasectomy). Furthermore, adjustment for social class, geographic region, religious affiliation, and family history of prostate cancer did not affect the RRs. The authors concluded that vasectomy does not increase the risk of prostate cancer, even at 25 years post-procedure or longer. Despite the fact that nearly all subjects (97%) were of European descent and, as such, the results may not apply to other ethnic groups, this study provides strong evidence to exclude an association between vasectomy and prostate cancer. To this end, men undergoing vasectomy can be reassured that they will not incur an increased risk of developing prostate cancer.
References
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