Nayan et al. BMJ (3/11/2016)
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Objective: To determine the association between vasectomy and prostate cancer, adjusting for measures of health seeking behaviour. Design: Population based matched cohort study. Setting Multiple validated healthcare databases in Ontario, Canada, 1994-2012. Participants 326 607 men aged 20 to 65 who had undergone vasectomy were identified through physician billing codes and matched 1:1 on age (within two years), year of cohort entry, comorbidity score, and geographical region to men who did not undergo a vasectomy. Main outcomes measures: The primary outcome was incident prostate cancer. Secondary outcomes were prostate cancer related grade, stage, and mortality. Results 3462 incident cases of prostate cancer were identified after a median follow-up of 10.9 years: 1843 (53.2%) in the vasectomy group and 1619 (46.8%) in the non-vasectomy group. In unadjusted analysis, vasectomy was associated with a slightly increased risk of incident prostate cancer (hazard ratio 1.13, 95% confidence interval 1.05 t |
“What is already known on this topic
- Studies evaluating the association between vasectomy and prostate cancer have provided conflicting results
- These studies have generally been limited by sample size and are prone to selection, recall, and detection biases
- Given the frequency of vasectomy, even a small increased risk of prostate cancer would constitute a major public health problem
What this study adds
- In this large population based study using validated healthcare databases, vasectomy does not seem to be independently associated with risk of prostate cancer
- These findings have important implications for patients, clinicians, guidelines, policy makers, and family planning support groups, and support the use of vasectomy as a safe method of contraception in men”