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Vasectomy and Prostate Cancer
The American Urological Association (AUA) and the AUA Foundation are aware of the recent controversy surrounding prostate cancer risk following vasectomy. However, the association feels that vasectomy is a safe method of surgical sterilization and men need not worry about an increased risk of developing prostate cancer after the procedure. Clinicians should be confident in advising their patients about the benefits and risks of surgical sterilization.
Two papers in the Journal of the American Medical Association (JAMA) in 1993 raised the possibility that vasectomy resulted in the increased incidence of prostate cancer. The AUA immediately formed a committee composed of Drs. John Grayhack, Patrick Walsh, Donald Coffey, Bert Peterson and Stuart Howards. This committee reviewed all the available data, and then formulated a position paper for the AUA, which stated that evidence was not convincing and that it was unlikely there was a relationship between vasectomy and prostate cancer. This opinion was based on the fact that the relationship was extremely weak although statistically significant in that there was no biologic rationale. The committee did recommend that clinicians advise patients who requested a vasectomy of the fact that some investigators felt there might be a relationship between vasectomy and prostate cancer. Soon after the AUA position paper, the National Institutes of Health (NIH) convened a conference involving Dr. Howards and many epidemiologists. The consensus statement of the NIH conference was that there was no convincing evidence of a relationship been vasectomy and prostate cancer and the NIH did not even recommend informing patients of the previous publications.
Since that time a large number of papers have been published which include more patients at risk for many more patient years than did the first two manuscripts. None of these papers have documented a relationship between vasectomy and prostate cancer. In 1998 Bernal-Delgado and Associates reviewed 14 existing papers on this subject including five cohort and nine case-control studies. Relative risk shown in these studies ranged between .44 and 6.75. The overall relative risk was not significant. They concluded that there was no casual relationship between vasectomy and prostate cancer. They also concluded that individuals who had undergone vasectomy are not at higher risk for developing prostate cancer. These authors did a population-based control study of 923 new cases of prostate cancer from the New Zealand Cancer Registry. They found there was no association between prostate cancer and vasectomy.
A June 2002 JAMA article provided reassuring data that indicated no correlation between prostate cancer risk and vasectomy. More than 1,000 men with prostate cancer and 1,800 men without the disease were contacted in a large retrospective study in New Zealand. Men were asked about various health data, including a history of having undergone a vasectomy; 9 percent of cancer patients and 10 percent of controls had undergone the procedure. The relative risk of prostate cancer was not increased in patients who had undergone vasectomy in the past.
In summary, papers published over the past nine years have conclusively documented that there is no increased risk of prostate cancer after vasectomy. Therefore, it is no longer imperative to inform patients of a possible risk and it is very safe to use vasectomy as a form of male sterilization.
- Fertility and Sterility, 1998: Vol. 70, Page 191-200)
- Cox et al, JAMA 287, page 3110-3115, 2002
Board of Directors, November 2002
Board of Directors, October 2007 (Reaffirmed)
Board of Directors, October 2008 (Revised)
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