American Journal of Epidemiology Vol. 132, No. 6: 1051-1055
Copyright © 1990 by The Johns Hopkins University School of Hygiene and Public Health
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VASECTOMY AND THE RISK OF PROSTATE CANCER
1Slone Epidemiology Unit, School of Public Health, Boston University School of Medicine Brookline, MA
2Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center New York, NY
3Cancer Care and Research Program, New York Hospital New York, NY
4Department of Public Health, Cornell Medical Center New York, NY
5Clinical Epidemiology Unit, University of Pennsylvania School of Medicine Philadelphia, PA
Reprint requests to Dr. Lynn Rosenberg, Slone Epidemiology Unit, School of Public Health, Boston University School of Medicine, 1371 Beacon Street, Brookline, MA 02146
An unexpected association between history of vasectomy and increased risk of prostate cancer emerged when multiple comparisons were canted out in data collected from 1976–1988 in a US hospital-based case-control study of many diseases and exposures. The association was assessed in detail in these data, In a comparison of 220 men with first episodes of prostate cancer with 571 noncancer controls and 960 cancer controls. The age-adjusted relative risk of prostate cancer was 5.3 (95% confidence interval 2.7–10) when noncancer controls were used and 3.5 (95 percent confidence interval 2.1–6.0) when cancer controls were used. The magnitude of the relative risk estimate appeared to be unrelated to the length of the interval after vasectomy. Allowance for several factors did not alter the estimates, but we did not have information on testoster one level or sexual activity, which may have been confounding factors. The association was stronger among men most likely to have been under more intensive medical surveillance; selective detection of asymptomatic cancer in such men would have led to an excess of cases. Further studies are needed to rule out chance, bias from medical surveillance, and uncontrolled confounding as explanations for the finding.
neoplasms; prostate; vasectomy
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