PURPOSE: Conflicting reports remain regarding the association between vasectomy, a common form of male contraception in the United States, and prostate cancer risk. We examined prospectively this association with extended follow-up and an emphasis on advanced and lethal disease. PATIENTS AND METHODS: Among 49,405 U.S. men in the Health Professionals Follow-Up Study, age 40 to 75 years at baseline in 1986, 6,023 patients with prostate cancer were diagnosed during the follow-up to 2010, including 811 lethal cases. In total, 12,321 men (25%) had vasectomies. We used Cox proportional hazards models to estimate the relative risk (RR) and 95% CIs of total, advanced, high-grade, and lethal disease, with adjustment for a variety of possible confounders. RESULTS: Vasectomy was associated with a small increased risk of prostate cancer overall (RR, 1.10; 95% CI, 1.04 to 1.17). Risk was elevated for high-grade (Gleason score 8 to 10; RR, 1.22; 95% CI, 1.03 to 1.45) and lethal disease (death or distant metastasis; RR, 1.19; 95% CI, 1.00 to 1.43). Among a subcohort of men receiving regular prostate-specific antigen screening, the association with lethal cancer was stronger (RR, 1.56; 95% CI, 1.03 to 2.36). Vasectomy was not associated with the risk of low-grade or localized disease. Additional analyses suggested that the associations were not driven by differences in sex hormone levels, sexually transmitted infections, or cancer treatment. CONCLUSION: Our data support the hypothesis that vasectomy is associated with a modest increased incidence of lethal prostate cancer. The results do not appear to be due to detection bias, and confounding by infections or cancer treatment is unlikely.
PURPOSE: Conflicting reports remain regarding the association between vasectomy, a common form of male contraception in the United States, and prostate cancer risk. We examined prospectively this association with extended follow-up and an emphasis on advanced and lethal disease. PATIENTS AND METHODS: Among 49,405 U.S. men in the Health Professionals Follow-Up Study, age 40 to 75 years at baseline in 1986, 6,023 patients with prostate cancer were diagnosed during the follow-up to 2010, including 811 lethal cases. In total, 12,321 men (25%) had vasectomies. We used Cox proportional hazards models to estimate the relative risk (RR) and 95% CIs of total, advanced, high-grade, and lethal disease, with adjustment for a variety of possible confounders. RESULTS: Vasectomy was associated with a small increased risk of prostate cancer overall (RR, 1.10; 95% CI, 1.04 to 1.17). Risk was elevated for high-grade (Gleason score 8 to 10; RR, 1.22; 95% CI, 1.03 to 1.45) and lethal disease (death or distant metastasis; RR, 1.19; 95% CI, 1.00 to 1.43). Among a subcohort of men receiving regular prostate-specific antigen screening, the association with lethal cancer was stronger (RR, 1.56; 95% CI, 1.03 to 2.36). Vasectomy was not associated with the risk of low-grade or localized disease. Additional analyses suggested that the associations were not driven by differences in sex hormone levels, sexually transmitted infections, or cancer treatment. CONCLUSION: Our data support the hypothesis that vasectomy is associated with a modest increased incidence of lethal prostate cancer. The results do not appear to be due to detection bias, and confounding by infections or cancer treatment is unlikely.
Authors: Thomas J Walsh; Michael Schembri; Paul J Turek; June M Chan; Peter R Carroll; James F Smith; Michael L Eisenberg; Stephen K Van Den Eeden; Mary S Croughan Journal: Cancer Date: 2010-05-01 Impact factor: 6.860
Authors: Bimal Bhindi; Christopher J D Wallis; Madhur Nayan; Ann M Farrell; Landon W Trost; Robert J Hamilton; Girish S Kulkarni; Antonio Finelli; Neil E Fleshner; Stephen A Boorjian; R Jeffrey Karnes Journal: JAMA Intern Med Date: 2017-09-01 Impact factor: 21.873
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Authors: Catherine M Tangen; Phyllis J Goodman; Cathee Till; Jeannette M Schenk; M Scott Lucia; Ian M Thompson Journal: J Clin Oncol Date: 2016-10-28 Impact factor: 44.544
Authors: Claire H Pernar; Ericka M Ebot; Andreas Pettersson; Rebecca E Graff; Francesca Giunchi; Thomas U Ahearn; Amparo G Gonzalez-Feliciano; Sarah C Markt; Kathryn M Wilson; Konrad H Stopsack; Elizaveta Gazeeva; Rosina T Lis; Giovanni Parmigiani; Eric B Rimm; Stephen P Finn; Edward L Giovannucci; Michelangelo Fiorentino; Lorelei A Mucci Journal: Eur Urol Date: 2018-10-06 Impact factor: 20.096