Heikki Seikkula1, Antti Kaipia2, Elli Hirvonen3, Matti Rantanen4, Janne Pitkäniemi5, Nea Malila6, Peter J Boström7. 1. Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland Keskussairaalantie 19, 40620, Jyväskylä, Finland. Electronic address: heikki.seikkula@ksshp.fi. 2. Department of Urology, Tampere University Hospital, Tampere, Finland PL 2000, 33521 Tampere, Finland. Electronic address: antti.kaipia@pshp.fi. 3. Finnish Cancer Registry, Helsinki, Finland Unioninkatu 22, 00130, Helsinki, Finland. Electronic address: elli.hirvonen@cancer.fi. 4. Finnish Cancer Registry, Helsinki, Finland Unioninkatu 22, 00130, Helsinki, Finland. Electronic address: matti.rantanen@cancer.fi. 5. Finnish Cancer Registry, Helsinki, Finland Unioninkatu 22, 00130, Helsinki, Finland. Electronic address: janne.pitkaniemi@cancer.fi. 6. Finnish Cancer Registry, Helsinki, Finland Unioninkatu 22, 00130, Helsinki, Finland; School of Health Sciences, University of Tampere, Finland. Electronic address: nea.malila@cancer.fi. 7. Department of Urology, Turku University Hospital, Turku, Finland, Department of Urology, University of Turku, Turku, Finland Kiinamyllynkatu 4-8, 20100, Turku, Finland. Electronic address: peter.bostrom@tyks.fi.
Abstract
INTRODUCTION & OBJECTIVES: There are conflicting reports on the association of vasectomy and the risk of prostate cancer (PCa). Our objective was to evaluate the association between vasectomy and PCa from a nationwide cohort in Finland. MATERIALS & METHODS: Sterilization registry of Finland and the Finnish Cancer Registry data were utilized to identify all men who underwent vasectomy between years 1987-2014 in Finland. Standard incidence ratio (SIR) for PCa as well as all-cause standardized mortality ratios (SMR) were calculated. RESULTS: We identified 38,124 men with vasectomy with a total of 429,937 person-years follow-up data. The median age at vasectomy was 39.7 years (interquartile range [IQR] 35.9-44.0), after vasectomy PCa was diagnosed in 413 men (122 cases 0-10 years, 219 cases 10-20 years and 72 cases >20 years from vasectomy). SIR for PCa for the vasectomy cohort was 1.15 (95% CI: 1.04-1.27). By the end of follow-up, 19 men had died from PCa, while the expected number was 20.5 (SMR 0.93 [95%CI: 0.56-1.44]). The overall mortality was decreased (SMR 0.54 [95%CI: 0.51-0.58]) among men with vasectomy. CONCLUSION: We found a small statistically significant increase in PCa incidence after vasectomy, but in contrast the mortality of vasectomized men was significantly reduced. This may be due to higher likelihood of vasectomized men to undergo prostate-specific antigen testing, having healthier general lifestyle and other biological factors e.g. high reproductive fitness.
INTRODUCTION & OBJECTIVES: There are conflicting reports on the association of vasectomy and the risk of prostate cancer (PCa). Our objective was to evaluate the association between vasectomy and PCa from a nationwide cohort in Finland. MATERIALS & METHODS: Sterilization registry of Finland and the Finnish Cancer Registry data were utilized to identify all men who underwent vasectomy between years 1987-2014 in Finland. Standard incidence ratio (SIR) for PCa as well as all-cause standardized mortality ratios (SMR) were calculated. RESULTS: We identified 38,124 men with vasectomy with a total of 429,937 person-years follow-up data. The median age at vasectomy was 39.7 years (interquartile range [IQR] 35.9-44.0), after vasectomy PCa was diagnosed in 413 men (122 cases 0-10 years, 219 cases 10-20 years and 72 cases >20 years from vasectomy). SIR for PCa for the vasectomy cohort was 1.15 (95% CI: 1.04-1.27). By the end of follow-up, 19 men had died from PCa, while the expected number was 20.5 (SMR 0.93 [95%CI: 0.56-1.44]). The overall mortality was decreased (SMR 0.54 [95%CI: 0.51-0.58]) among men with vasectomy. CONCLUSION: We found a small statistically significant increase in PCa incidence after vasectomy, but in contrast the mortality of vasectomized men was significantly reduced. This may be due to higher likelihood of vasectomized men to undergo prostate-specific antigen testing, having healthier general lifestyle and other biological factors e.g. high reproductive fitness.