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Vasectomy does not increase prostate cancer risk

Having a vasectomy does not increase a man’s risk for high-grade, advanced stage or fatal prostate cancer, according to findings published in JAMA Internal Medicine.

“Despite 3 decades of study, there remains ongoing debate regarding whether vasectomy is associated with prostate cancer,” Bimal Bhindi, MDCM, MSc, from the department of urology at Mayo Clinic, Rochester, Minnesota, and colleagues wrote.

To better understand the association, Bhindi and colleagues conducted a systematic review and meta-analysis of 53 studies including 16 cohort studies (n = 2,563,519), 33 case-control studies (n = 44,536) and four cross-sectional studies (n = 12,098,221) that evaluated the relative effect estimates for the relationship between vasectomy and prostate cancer. A moderate-to-high risk for bias was apparent in seven cohort studies (44%), 26 case-control studies (79%) and all four cross-sectional studies.

Among seven cohort studies with low risk for bias, there was a weak association between vasectomy and prostate cancer (adjusted RR = 1.05; 95% CI, 1.02-1.09), whereas data from six case-control studies showed a similar but nonsignificant association (adjusted RR = 1.06; 95%CI, 0.88-1.29). When the researchers included studies with a moderate-to-high risk for bias, they found that effect estimates were stronger.

In all cohort studies, there were no significant associations between vasectomy and high-grade prostate cancer (adjusted RR = 1.03; 95% CI, 0.89-1.21), advanced prostate cancer (adjusted RR = 1.08; 95% CI, 0.98-1.2) and fatal prostate cancer (adjusted RR = 1.02; 95% CI, 0.92-1.14). The absolute increase in lifetime risk for prostate cancer as a result of vasectomy was 0.6% (95% CI, 0.3-1.2). In the population, vasectomy would be the cause of only 0.5% of cases of prostate cancer.

“At most, there is a trivial association between vasectomy and prostate cancer that is unlikely to be causal; therefore, concerns about prostate cancer should not preclude the use of vasectomy as an option for long-term contraception,” Bhindi and colleagues concluded. – by Alaina Tedesco

Disclosure: The researchers report no relevant financial disclosures.