Vasectomy and risk for prostate cancer — yet again …


So now we have data from a prospective study (carried out as part of the European Prospective Investigation into Cancer and Nutrition) that was designed (in part) to explore whether there was any association between vasectomy and risk for prostate cancer.

In a recently published paper in the Journal of Clinical Oncology, Byrne et al. report data from their study of 84,753 men from Denmark, Germany, Spain, and the United Kingdom, all aged between 35 and 79 years, who provided information on vasectomy status at the time of recruitment and who were the followed prospectively to establish incidence of prostate cancer and prostate cancer-specific mortality.

The full text of the article by Byrne et al. is available on line.

The authors report that:

  • Average (mean) age of men at recruitment was 53 years.
  • Average (mean) age of men at diagnosis with prostate cancer was 68 years.
  • Average (median) follow-up was 15.4 years (range 0 to 20 years).
  • 12,712/84,753 patients (15.0 percent) had already had a vasectomy at time of study enrollment.
  • Prostate cancer was diagnosed in
    • 4,377/84,753 participants (5.2 percent) in total
    • 641/12,712 participants (5.0 percent) who had had a vasectomy
    • 3,736/72,041 participants (5.2 percent) who had not had a vasectomy
  • There was no evidence that having a vasectomy was associated with
    • Increased risk for prostate cancer (hazard ratio [HR] = 1.05)
    • Increased risk for prostate cancer-specific mortality (HR = 0.83)
  • There was some evidence of heterogeneity of risk by tumor grade (P = 0.02), since having a vasectomy was associated with
    • Increased risk for low- and intermediate-grade prostate cancer (HR = 1.14)
    • No increase in risk for high-grade prostate cancer (HR = 0.83)
  • There was no evidence of hetereogeneity of risk based on
    • Stage of disease at diagnosis
    • Years since vasectomy

Data from the study also confirmed an oft-mentioned prior suspicion — that men who had had a vasectomy were also more likely to get PSA tests for risk of prostate cancer. In other words, men who had a vasectomy tended to exhibit “health-seeking behavior” to a higher degree than the men who did not have a vasectomy. This health-seeking behavior inevitably increased the possibility that such men would be diagnosed with the low- and intermediate-risk forms of prostate cancer most likely to be diagnosed based on PSA alone.

The authors conclude that their study

did not find a significant association between vasectomy and overall prostate cancer, high-grade or advanced-stage tumors, or death due to prostate cancer. The small increase in the risk of low-intermediate–grade prostate cancer in men who had had a vasectomy may be due to differences in health-monitoring behaviors.

It is unlikely that this study will actually end men’s worries that having a vasectomy might be associated with an increased risk for prostate cancer (after all, some men are looking for any excuse not to have a vasectomy). However, what this study does do is suggest that if there is any increase in risk it is certainly small, and it is most likely to be an increase in risk for low-risk forms of prostate cancer that are unlikely to lead to metastasis or prostate cancer-specific mortality anyway.

3 Responses

  1. Sitemaster,

    I have been waiting years, on pins and needles, for the real reason why I was diagnosed with high-risk prostate cancer in 2008 at age 52. I am disappointed you reported (again) on a causation myth. I had had a vasectomy several years before my diagnosis and was hoping a new study would prove that was the cause (so I could blame the person who recommended I have one — my spouse).

    I had (and still have) a full head of hair. I was not overweight. I exercised regularly. I wore loose fitting underwear. I am now left to ponder that the only real cause of my prostate cancer was my penchant for a well-charred chicken leg.

    Thanks for keeping us informed!

    Richard

  2. Dear Richard:

    I have a brief recommendation related to your quality of life. … Perchance it is time to step off your preferred form of flooring (the pins and needles) and try standing on something more comfortable (e.g., carpet?).

    :O)

  3. I had a vasectomy and almost immediately started having urological issues. Two years later, diagnosed with stage IV prostate cancer. I have seen several articles like this, some seem to indicate that younger men are more likely to have aggressive prostate cancer if they have a vasectomy. That’s me, 47 at vasectomy, 49 at diagnosis of aggressive prostate cancer.

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