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Vasectomy and the risk of prostate cancer: a meta-analysis examining vasectomy status, age at vasectomy, and time since vasectomy

Abstract

The aim of this study was to conduct a quantitative review of prostate cancer studies to pool relative risk (RR) estimates on the association between prostate cancer and vasectomy, in an attempt to determine whether there is an association, and if so, its magnitude. Random-effects models were examined along with a linear model for time since vasectomy. The pooled RR estimate was 1.37 (95% CI=1.15–1.62) based on five cohort studies and 17 case–control studies. The RR estimate varied by study design with the lowest risk for population-based case–control studies. No difference was seen in risk by age at vasectomy. A linear trend based on the 16 studies reporting time since vasectomy suggested an 10% increase for each additional 10 y or a RR of 1.32 (95% CI=1.17–1.50) for 30 y since vasectomy. When null effects were assumed for the six studies not reporting information, the linear RR for the 22 studies was 1.07 (1.03–1.11) and 1.23 (1.11–1.37) for 10 and 30 y since vasectomy, respectively. These results suggest that men with a prior vasectomy may be at an increased risk of prostate cancer, however, the increase may not be causal since potential bias cannot be discounted. The overall association was small and therefore could be explained by bias. The latency effect shown here for time since vasectomy should be examined further.

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References

  1. Jemal A, Thomas A, Murray T, Thun M . Cancer statistics, 2002 CA Cancer J Clin 2002 52: 23–47

    Article  Google Scholar 

  2. Schlegel PN, Goldstein M . Vasectomy In: Shoupe D, Haseltine FP (eds) Contraception Springer-Verlag: New York 1993 pp 181–191

    Chapter  Google Scholar 

  3. Schwingl PJ, Guess HA . Safety and effectiveness of vasectomy Fertil Steril 2000 73: 923–936

    Article  CAS  Google Scholar 

  4. DerSimonian R, Clemens J, Spirtas R, Perlman J . Vasectomy and prostate cancer risk: methodological review of the evidence J Clin Epidemiol 1993 46: 163–172

    Article  CAS  Google Scholar 

  5. Spitz MR et al. Vasectomy and the risk of prostate cancer (Letter) Am J Epidemiol 1991 134: 108–109

    Article  Google Scholar 

  6. Newell GR, Fueger JJ, Spitz MR, Babaian RJ . A case control study of prostate cancer Am J Epidemiol 1989 130: 395–398

    Article  CAS  Google Scholar 

  7. Bernal-Delgado E, Latour-Perez J, Pradas-Arnal F, Gomez-Lopez LI . The association between vasectomy and prostate cancer: a systematic review of the literature Fertil Steril 1998 70: 191–200

    Article  CAS  Google Scholar 

  8. Andersson S-O et al. Lifestyle factors and prostate cancer risk: a case-control study in Sweden Cancer Epidemiol 1996 5: 509–513

    CAS  Google Scholar 

  9. Ewings P, Bowie C . A case–control study of cancer of the prostate in Somerset and east Devon Br J Cancer 1996 74: 661–666

    Article  CAS  Google Scholar 

  10. Giovannucci E et al. A prospective cohort study of vasectomy and prostate cancer in US men JAMA 1993 269: 873–877

    Article  CAS  Google Scholar 

  11. Woolf B . On estimating the relation between blood group and disease Ann Hum Genet 1955 19: 251–253

    Article  CAS  Google Scholar 

  12. DerSimonian R, Laird N . Meta-analysis in clinical trials Controlled Clinical Trials 1986 7: 177–188

    Article  CAS  Google Scholar 

  13. Greenland S, Longnecker MP . Methods for trend estimation from summarized dose–response data, with applications to meta-analysis Am J Epidemiol 1992 135: 1301–1309

    Article  CAS  Google Scholar 

  14. Berlin JA, Longnecker MP, Greenland S . Meta-analysis of epidemiologic dose–response data Epidemiology 1993 4: 218–228

    Article  CAS  Google Scholar 

  15. Sidney S et al. Vasectomy and the risk of prostate cancer in a cohort of multiethnic health-checkup examinees: second report Cancer Causes Control 1991 2: 113–116

    Article  CAS  Google Scholar 

  16. Sidney S . Vasectomy and the risk of prostate cancer and benign prostate hypertrophy J Urol 1987 138: 795–797

    Article  CAS  Google Scholar 

  17. Hiatt RA, Armstrong MA, Klatsky AL, Sidney S . Alcohol consumption, smoking, and other risk factors and prostate cancer in a large health plan cohort in California (United States) Cancer Causes Control 1994 5: 66–72

    Article  CAS  Google Scholar 

  18. Nienhuis H et al. Incidence of disease after vasectomy: a record linkage retrospective cohort study Br Med J 1992 304: 743–746

    Article  CAS  Google Scholar 

  19. Giovannucci E et al. A retrospective cohort study of vasectomy and prostate cancer in US men JAMA 1993 269: 878–872

    Article  CAS  Google Scholar 

  20. Møller H, Mellemgaard A, Lindvig K, Olsen JH . Obesity and cancer risk: a Danish record linkage study Eur J Cancer 1994 30A: 344–350

    Article  Google Scholar 

  21. Ross RK, Paganini-Hill A, Henderson BE . The etiology of prostate cancer: what does the epidemiology suggest? Prostate 1983 4: 333–344

    Article  CAS  Google Scholar 

  22. Honda GD et al. Vasectomy, cigarette smoking, and age at first sexual intercourse as risk for prostate cancer in middle-aged men Br J Cancer 1988 57: 326–331

    Article  CAS  Google Scholar 

  23. Hayes RB et al. Vasectomy and prostate cancer in US blacks and whites Am J Epidemiol 1993 137: 263–269

    Article  CAS  Google Scholar 

  24. Hsing AW et al. Vasectomy and prostate cancer risk in China Cancer Epidemiol Biomarkers Prev 1994 3: 285–288

    CAS  PubMed  Google Scholar 

  25. John EM et al. Vasectomy and prostate cancer: results from a multiethnic case-control study J Natl Cancer Inst 1995 87: 662–669

    Article  CAS  Google Scholar 

  26. Zhu K et al. Vasectomy and prostate cancer: a case-control study in a health maintenance organization Am J Epidemiol 1996 144: 717–722

    Article  CAS  Google Scholar 

  27. Lesko SM et al. Vasectomy and prostate cancer J Urol 1999 161: 1848–1853

    Article  CAS  Google Scholar 

  28. Stanford JL et al. Vasectomy and risk of prostate cancer Cancer Epidemiol Biomarkers Prev 1999 8: 881–886

    CAS  PubMed  Google Scholar 

  29. Mettlin C, Natarajan N, Huben R . Vasectomy and prostate cancer risk Am J Epidemiol 1990 132: 1056–1061

    Article  CAS  Google Scholar 

  30. Rosenberg L et al. Vasectomy and risk of prostate cancer Am J Epidemiol 1990 132: 1051–1055

    Article  CAS  Google Scholar 

  31. Peterson DE, Remington PL, Anderson HA . Re: Vasectomy and the risk of prostate cancer (letter) Am J Epidemiol 1992 135: 324–325

    Article  CAS  Google Scholar 

  32. Rosenberg L et al. The relation of vasectomy to the risk of cancer Am J Epidemiol 1994 140: 431–438

    Article  CAS  Google Scholar 

  33. Platz EA et al. Vasectomy and prostate cancer: a case-control study in India Int J Epidemiol 1997 26: 933–938

    Article  CAS  Google Scholar 

  34. Emard JF, Drouin G, Thouez JP, Ghadirian P . Vasectomy and prostate cancer in Quebec, Canada Health Place 2001 7: 131–139

    Article  CAS  Google Scholar 

  35. Dennis LK, Dawson DV . Meta-analysis combining risks of measures of sexual activity and prostate cancer Epidemiology 2002 13: 72–79

    Article  Google Scholar 

  36. Rosenthal R . The ‘file drawer problem’ and the tolerance for null results Psych Bull 1979 86: 638–641

    Article  Google Scholar 

  37. Simes RJ . Confronting publication bias: a cohort design for meta-analysis Stat Med 1987 6: 11–29

    Article  CAS  Google Scholar 

  38. Howards SS . Possible biological mechanisms for a relationship between vasectomy and prostate cancer Eur J Cancer 1993 29A: 1060–1062

    Article  CAS  Google Scholar 

  39. Jarow JP et al. Quantitative pathologic changes in the human testis after vasectomy. A controlled study New Engl J Med 1985 313: 1252–1256

    Article  CAS  Google Scholar 

  40. Jarow JP, Goluboff ET, Chang TS, Marshall FF . relationship between antisperm antibodies and testicular histologic changes in humans after vasectomy Urology 1994 43: 521–524

    Article  CAS  Google Scholar 

  41. Ries LAG et al (eds). SEER Cancer Statistics Review, 1973–1997 National Cancer Institute, Bethesda, MD 2000

    Google Scholar 

  42. Shapiro DA, Shapiro D . Meta-analysis of comparative therapy outcome studies: a replication and refinement Psych Bull 1982 92: 581–604

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This research was supported by the NCI, grant number CA-78201-01A1.

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Correspondence to L K Dennis.

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Dennis, L., Dawson, D. & Resnick, M. Vasectomy and the risk of prostate cancer: a meta-analysis examining vasectomy status, age at vasectomy, and time since vasectomy. Prostate Cancer Prostatic Dis 5, 193–203 (2002). https://doi.org/10.1038/sj.pcan.4500586

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