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| References
- Vasectomy |
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16.
Giovannucci E, Ascherio A, Rimm EB, Colditz GA, Stampfer MJ,
Willett WC. A prospective cohort study of vasectomy and prostate
cancer in US men. JAMA 1993;269:873-7.
Abstract:
OBJECTIVE--To examine prospectively the relationship between
vasectomy and prostate cancer. DESIGN--Cohort study. SETTING--Health
professionals (dentists, veterinarians, osteopaths, optometrists,
pharmacists, and podiastrists) in the United States. PARTICIPANTS--There
were 10,055 male members of the Health Professionals Follow-up
Study, aged 40 to 75 years, who had had a vasectomy, and 37,800
members who had not had a vasectomy at the time of study entry
in 1986. These participants had provided detailed information
on various life-style variables including diet. MAIN OUTCOME
MEASURE--Diagnosis of prostate cancer. RESULTS--Between 1986
and 1990, 300 new cases of prostate cancer were diagnosed
in participants who were initially free of diagnosed cancer.
Vasectomy was associated with an elevated risk of prostate
cancer (age-adjusted relative risk, 1.66; 95% confidence interval,
1.25 to 2.21; P = .0004). This elevated risk persisted after
excluding 21 stage A1 cases (age-adjusted relative risk, 1.56;
95% confidence interval, 1.15 to 2.11; P = .004). Among men
who had their vasectomy at least 22 years in the past (before
1965), the risk of prostate cancer was even higher (relative
risk, 1.85; 95% confidence interval, 1.26 to 2.72; P = .002).
This elevated risk among men with vasectomy did not appear
to be caused by detection bias and persisted when we controlled
for diet, level of physical activity, smoking, alcohol consumption,
educational level, body mass index, and geographical area
of residence. CONCLUSIONS--These results support evidence
from other epidemiologic studies that vasectomy increases
risk of prostate cancer. The consistency of results among
various epidemiologic studies, the increase of risk over time
following vasectomy, the apparent lack of confounding or bias,
and the existence of physiological changes in the prostate
following vasectomy suggest that the association may be causal
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