The Association Between Vasectomy and Prostate Cancer

Abstract

IMPORTANCE Despite 3 decades of study, there remains ongoing debate regarding whether vasectomy is associated with prostate cancer.OBJECTIVE To determine if vasectomy is associated with prostate cancer.DATA SOURCES The MEDLINE, EMBASE, Web of Science, and Scopus databases were searched for studies indexed from database inception to March 21, 2017, without language restriction.STUDY SELECTION Cohort, case-control, and cross-sectional studies reporting relative effect estimates for the association between vasectomy and prostate cancer were included. DATA EXTRACTION AND SYNTHESISTwo investigators performed study selection independently. Data were pooled separately by study design type using random-effects models. The Newcastle-Ottawa Scale was used to assess risk of bias. MAIN OUTCOMES AND MEASURESThe primary outcome was any diagnosis of prostate cancer. Secondary outcomes were high-grade, advanced, and fatal prostate cancer.RESULTS Fifty-three studies (16 cohort studies including 2 563 519 participants, 33 case-control studies including 44 536 participants, and 4 cross-sectional studies including 12 098 221 participants) were included. Of these, 7 cohort studies (44%), 26 case-control studies (79%), and all 4 cross-sectional studies were deemed to have a moderate to high risk of bias. Among studies deemed to have a low risk of bias, a weak association was found among cohort studies (7 studies; adjusted rate ratio, 1.05; 95% CI, 1.02-1.09; P < .001; I 2 = 9%) and a similar but nonsignificant association was found among case-control studies (6 studies; adjusted odds ratio, 1.06; 95% CI, 0.88-1.29; P = .54; I 2 = 37%). Effect estimates were further from the null when studies with a moderate to high risk of bias were included. Associations between vasectomy and high-grade prostate cancer (6 studies; adjusted rate ratio, 1.03; 95% CI, 0.89-1.21; P = .67; I 2 = 55%), advanced prostate cancer (6 studies; adjusted rate ratio, 1.08; 95% CI, 0.98-1.20; P = .11; I 2 = 18%), and fatal prostate cancer (5 studies; adjusted rate ratio, 1.02; 95% CI, 0.92-1.14; P = .68; I 2 = 26%) were not significant (all cohort studies). Based on these data, a 0.6% (95% CI, 0.3%-1.2%) absolute increase in lifetime risk of prostate cancer associated with vasectomy and a population-attributable fraction of 0.5% (95% CI, 0.2%-0.9%) were calculated.CONCLUSIONS AND RELEVANCE This review found no association between vasectomy and high-grade, advanced-stage, or fatal prostate cancer. There was a weak association between vasectomy and any prostate cancer that was closer to the null with increasingly robust study design. This association is unlikely to be causal and should not preclude the use of vasectomy as a long-term contraceptive option.

Vasectomy is family planning: factors affecting uptake among men in eastern province of Rwanda

“…There was no statistical association. Our findings are similar to a Nigerian study,[18] and a recent meta-analysis [25] revealed there was no statistical relationship between vasectomy and high-grade, advanced-stage, or terminal prostate cancer.…”

“…Other studies had similar findings. [18,25] A review of the RDHS 2010 indicted Protestants in Rwanda were more likely than other religions to desire more than three children. [23] A study in Malaysia with 330 medical students, [13] revealed that men of Islamic religion had a positive attitude towards vasectomy (61.6%) and high acceptance (76.1%); Christians were positive (62.5%), and high acceptance (100%); Hindus had a positive attitude (66.6%) and high acceptance (66.6%), whereas Buddhism students were not positive (16.7%), though somewhat accepting of vasectomy (50%).…”

Management and outcomes of pregnancy with or without lupus nephritis: a systematic review and meta-analysis

“…A score ≥7 in cohort studies and ≥6 in cross-sectional studies were indicative of a high quality study. 17 Furthermore, each study was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist, which is a 22-item checklist that assesses the essential items of observational studies. 18 The purpose of STROBE is not to assess quality, but to ensure clear presentation of the study.…”

Latest Evidence on the Impact of Smoking, Sports, and Sexual Activity as Modifiable Lifestyle Risk Factors for Prostate Cancer Incidence, Recurrence, and Progression: A Systematic Review of the Literature by the European Association of Urology Section of Oncological Urology (ESOU)

“…Vasectomy has been discussed as a putative risk factor for PCa development over recent decades, and some studies have supported an association with lethal PCa [100]. On the contrary, most recent studies found either no or only a weak association between vasectomy and overall PCa risk (closer to the null with increasingly robust study design) and no significant association with HGPCA, advanced-stage PCa, or fatal PCa, finally resulting in currently strong evidence rebutting a relationship between vasectomy and PCa [101][102][103][104][105].…”