Vasectomy and risk of prostate cancer: population based matched cohort study

doi:10.1136/bmj.i5546

. 2016 Nov 3:355:i5546.

doi: 10.1136/bmj.i5546.

Vasectomy and risk of prostate cancer: population based matched cohort study

Affiliations

¹ Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, 610 University Ave 3-130, Toronto, ON, M5G 2M9, Canada madhur.nayan@mail.utoronto.ca.
² Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, 610 University Ave 3-130, Toronto, ON, M5G 2M9, Canada.
³ Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
⁴ Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.
⁵ Ontario Institute for Cancer Research, Toronto, ON, Canada.
⁶ Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Lunenfeld Tannenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
⁷ Department of Internal Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.

PMID: 27811008
PMCID: PMC5094198
DOI: 10.1136/bmj.i5546

Vasectomy and risk of prostate cancer: population based matched cohort study

Madhur Nayan et al. BMJ. 2016.

. 2016 Nov 3:355:i5546.

doi: 10.1136/bmj.i5546.

Authors

Affiliations

¹ Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, 610 University Ave 3-130, Toronto, ON, M5G 2M9, Canada madhur.nayan@mail.utoronto.ca.
² Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, 610 University Ave 3-130, Toronto, ON, M5G 2M9, Canada.
³ Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
⁴ Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.
⁵ Ontario Institute for Cancer Research, Toronto, ON, Canada.
⁶ Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Lunenfeld Tannenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
⁷ Department of Internal Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.

PMID: 27811008
PMCID: PMC5094198
DOI: 10.1136/bmj.i5546

Abstract

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 to 1.20). After adjustment for measures of health seeking behaviour, however, no association remained (adjusted hazard ratio 1.02, 95% confidence interval 0.95 to 1.09). Moreover, no association was found between vasectomy and high grade prostate cancer (adjusted odds ratio 1.05, 95% confidence interval 0.67 to 1.66), advanced stage prostate cancer (adjusted odds ratio 1.04, 0.81 to 1.34), or mortality (adjusted hazard ratio 1.06, 0.60 to 1.85).

Conclusion: The findings do not support an independent association between vasectomy and prostate cancer.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

None — **Fig 1** Cumulative probability of incident prostate cancer by vasectomy status

See this image and copyright information in PMC

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References

1. Farley TM, Meirik O, Mehta S, Waites GM. The safety of vasectomy: recent concerns. Bull World Health Organ 1993;71:413-9.pmid:8324861. - PMC - PubMed
1. Jacobstein R, Pile J. Vasectomy: safe, convenient, effective—and underutilized. Global Health Technical Briefs. 2005.
1. Trussell J, Lalla AM, Doan QV, Reyes E, Pinto L, Gricar J. Cost effectiveness of contraceptives in the United States. Contraception 2009;79:5-14. 10.1016/j.contraception.2008.08.003 pmid:19041435. - DOI - PMC - PubMed
1. Jamieson DJ, Costello C, Trussell J, Hillis SD, Marchbanks PA, Peterson HB. US Collaborative Review of Sterilization Working Group. The risk of pregnancy after vasectomy. Obstet Gynecol 2004;103:848-50. 10.1097/01.AOG.0000123246.11511.e4 pmid:15121555. - DOI - PubMed
1. Pile JM, Barone MA. Demographics of vasectomy--USA and international. Urol Clin North Am 2009;36:295-305. 10.1016/j.ucl.2009.05.006 pmid:19643232. - DOI - PubMed

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[1] Farley TM, Meirik O, Mehta S, Waites GM. The safety of vasectomy: recent concerns. Bull World Health Organ 1993;71:413-9.pmid:8324861. - PMC - PubMed

[2] Farley TM, Meirik O, Mehta S, Waites GM. The safety of vasectomy: recent concerns. Bull World Health Organ 1993;71:413-9.pmid:8324861. - PMC - PubMed

[3] Jacobstein R, Pile J. Vasectomy: safe, convenient, effective—and underutilized. Global Health Technical Briefs. 2005.

[4] Jacobstein R, Pile J. Vasectomy: safe, convenient, effective—and underutilized. Global Health Technical Briefs. 2005.

[5] Trussell J, Lalla AM, Doan QV, Reyes E, Pinto L, Gricar J. Cost effectiveness of contraceptives in the United States. Contraception 2009;79:5-14. 10.1016/j.contraception.2008.08.003 pmid:19041435. - DOI - PMC - PubMed

[6] Trussell J, Lalla AM, Doan QV, Reyes E, Pinto L, Gricar J. Cost effectiveness of contraceptives in the United States. Contraception 2009;79:5-14. 10.1016/j.contraception.2008.08.003 pmid:19041435. - DOI - PMC - PubMed

[7] Jamieson DJ, Costello C, Trussell J, Hillis SD, Marchbanks PA, Peterson HB. US Collaborative Review of Sterilization Working Group. The risk of pregnancy after vasectomy. Obstet Gynecol 2004;103:848-50. 10.1097/01.AOG.0000123246.11511.e4 pmid:15121555. - DOI - PubMed

[8] Jamieson DJ, Costello C, Trussell J, Hillis SD, Marchbanks PA, Peterson HB. US Collaborative Review of Sterilization Working Group. The risk of pregnancy after vasectomy. Obstet Gynecol 2004;103:848-50. 10.1097/01.AOG.0000123246.11511.e4 pmid:15121555. - DOI - PubMed

[9] Pile JM, Barone MA. Demographics of vasectomy--USA and international. Urol Clin North Am 2009;36:295-305. 10.1016/j.ucl.2009.05.006 pmid:19643232. - DOI - PubMed

[10] Pile JM, Barone MA. Demographics of vasectomy--USA and international. Urol Clin North Am 2009;36:295-305. 10.1016/j.ucl.2009.05.006 pmid:19643232. - DOI - PubMed

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Vasectomy and risk of prostate cancer: population based matched cohort study

Affiliations

Vasectomy and risk of prostate cancer: population based matched cohort study

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