American Journal of Epidemiology Vol. 140, No. 5: 431-438
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
The Relation of Vasectomy to the Risk of Cancer
1Slone Epidemiology Unit, School of Public Health, Boston University School of Medicine Brooldine, 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 and Department of Public Health, Cornell Medical Center New York, NY.
4Center for Clinical Epidemiology and Biostatistics and Division of General Internal Medicine, University of Pennsylvania School of Medicine Philadelphia, PA.
Reprint requests to Dr. Lynn Rosenberg, Slone Epidemiology Unit, 1371 Beacon Street, Brookline, MA 02146
We previously reported a strong positive association between vasectomy and the risk of prostatic cancer that arose in multiple comparisons made within data collected from 1976 to 1988 in an ongoing hospital-based surveillance study of many exposures and diseases. We have reassessed this association with data collected in the surveillance study during 19881992 from a new set of patients (355 cases of prostatic cancer and 2,048 controls with nonmalignant conditions). Because some studies have reported increased relative risks of lung cancer and testicular cancer in vasectomized men, we also used the surveillance database (4,126 men with various cancers, 7,027 men with nonmalignant conditions) to assess the relation of vasectomy to the risk of these and other cancers. In the newly collected data, the muttivariate relative risk estimate for prostatic cancer in vasectomized men was 1.2 (95% confidence interval (Cl) 0.62.7). For lung cancer and testicular cancer, the relative risk estimates were 1.3 (95% Cl 0.82.1) and 0.8(95% Cl 0.41.9), respectively; for lung cancer occurring
15 years after vasectomy, the relative risk estimate was 1.9 but it was not statistically significant (95% Cl 0.75.0). For pancreatic cancer, the relative risk estimate was 1.8 (95% Cl 1.03.1). For each of the other cancers consideredmalignant melanoma, large bowel cancer, bladder cancer, kidney cancer, lyrnphoma, leukemia, and other cancersthe relative risk estimate was 1.3 or less and compatible with a value of 1.0. The present data provide little support for an association of vasectomy with the risk of prostatic cancer or other cancers. In addition, the data from two sets of cases of prostatic cancer and controls Interviewed consecutively illustrate that increased rel ative risks detected in screening for statistically significant associations may tend to have an upward bias and to be lower in subsequent data.
neoplasms; prostatic neoplasms; vasectomy
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