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#Grand Rounds

Are Vasectomies Linked to Higher Risk for Prostate Cancer?

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BACKGROUND AND PURPOSE:

  • Literature exists to both support and dispute the link between vasectomy and prostate cancer
  • Bhindi et al. (JAMA Intern Med, 2017) reviewed the association between vasectomy and prostate cancer

METHODS:

  • Systematic review and meta-analysis
  • 53 Pooled cohort, case-control, and cross-sectional studies were included
    • Total of 14,706,276 participants
  • Primary outcome
    • Any diagnosis of prostate cancer
  • Secondary outcomes
    • High-grade, advanced, and fatal prostate cancer

RESULTS:

  • Among studies deemed to have a low risk of bias
    • Cohort studies: There was a weak association found between vasectomy and prostate cancer
      • adjusted rate ratio, 1.05; 95% CI, 1.02-1.09; P < .001; 7 studies
      • This association become more pronounced with studies that had poorer design and greater risk of bias
    • Among case control studies, there was a similar rate ratio but it was insignificant
    • When assessing secondary outcomes, there were no associations between vasectomy and high-grade prostate cancer, advanced prostate cancer, and fatal prostate cancer
    • There is 0.6% absolute increase in lifetime risk of prostate cancer associated with vasectomy

CONCLUSION:

  • There is no significant association between vasectomy and high-grade, advanced, or fatal prostate cancer
  • There was a weak association with prostate cancer that moved toward the null hypothesis and insignificance the better the study design
    • Therefore even if there is an association, it is unlikely to be causal
  • Vasectomy should not be discouraged based on risk of prostate cancer

Learn More – Primary Sources:

The Association Between Vasectomy and Prostate Cancer: A Systematic Review and Meta-analysis

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Related ObG Topics:

Obstetrics Critical Care Course
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