According to the National Cancer Institute, one in six American men over age 35 has had a vasectomy. Since the early 1990s, there has been some debate about whether a vasectomy increases the risk of developing prostate cancer. A few studies have suggested that men who have undergone vasectomy may be more likely to develop prostate cancer, while other studies have found no association between vasectomy and prostate cancer. Some scientists suspect that vasectomized men may be more likely to be diagnosed with prostate cancer only because they see a doctor more often than un-vasectomized men.
A study published in the June 19, 2002 issue of the Journal of the American Medical Association found no increased risk of prostate cancer among men who had undergone vasectomy.
This study was a case-control study, meaning that men with prostate cancer (cases) and without (controls) were studied. Researchers from the University of Otago Medical School in New Zealand enrolled 2147 New Zealand men of European descent between the ages of 40 and 74. Cases were 923 men who had been diagnosed with prostate cancer between April 1, 1996 and December 31, 1998. Controls were 1224 men without prostate cancer who had been randomly selected from the New Zealand electoral rolls. Controls were matched to cases based on age in 5-year intervals (for example, 40 to 45).
Between January 1997 and November 1999, cases and controls were interviewed via telephone about previous illnesses, vasectomy, smoking and alcohol consumption, PSA testing (a screening test for prostate cancer), digital rectal exam, previous urological symptoms and operations, and family history of cancer. They also provided social and demographic information.
The researchers compared the number of vasectomies among cases (men with prostate cancer) versus controls.
Men who had undergone vasectomy were no more likely to have developed prostate cancer than men who had not undergone vasectomy. This was true even for men who had undergone vasectomy more than 25 years prior to being interviewed for the study.
In testing this association, the researchers also assessed the effects of other factors on the risk of prostate cancer. They found that men with a brother or father who had developed prostate cancer were more than 2.5 times more likely to develop prostate cancer than men with no family history of the disease. Alcohol consumption, smoking, and number of children were not associated with prostate cancer risk.
Although these results are interesting, there are limitations to this study. Because dietary information was not collected, any effects of dietary habits on prostate cancer risk are not accounted for in these findings. In addition, the men in this study were New Zealanders of European ancestry, so more research is needed to determine whether these results apply to men of other racial and ethnic groups.
Research to date on a possible connection between vasectomy and prostate cancer has yielded conflicting results. This large, population-based study supports the evidence that vasectomy does not increase a man’s risk of developing prostate cancer. New Zealand has the highest rate of vasectomy in the world and mandatory reporting of all cancers to the National Cancer Registry, making this country an ideal place to study a possible association between vasectomy and prostate cancer.
Is it safe to have a vasectomy? Urologists still consider vasectomy a safe and effective procedure. However, in light of the conflicting evidence, urologists tend to screen vasectomized men for prostate cancer more often than un-vasectomized men in an effort to catch and treat any potential cancers early when success rates are higher. In addition, they discourage vasectomy among men with a family history of prostate cancer.
An expert panel of the National Institutes of Health has concluded that even if undergoing a vasectomy might increase a man’s risk of developing prostate cancer, the increase in risk is relatively small. The National Cancer Institute recommends that men concerned about prostate cancer talk to their doctor about the symptoms to watch for and an appropriate schedule for checkups.
Source:
Cox B, et al. Vasectomy and risk of prostate cancer. Journal of the American Medical Association . June 19, 2002;287(23):3110-3115.
Last reviewed June 19, 2002 by Richard Glickman-Simon, MD
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