Considering a vasectomy? Consider possible risks first

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chemotherapyA recent study from the Harvard School of Public Health suggests vasectomies are associated with an increased risk of advanced or lethal prostate cancer.

Both prostate cancer and vasectomies are common in the United States. Prostate cancer remains the most common cancer diagnosis among men, and is the second-leading cause of cancer death in men in the nation. Vasectomies are widely used as a form of contraception, as 15 percent of men opt for the procedure. In light of these facts, the authors of this study sought to determine if there was a link between lethal prostate cancer and vasectomy.

Researchers evaluated data from 49,405 men in the United States who participated in the Health Professions Follow-up Study. There was a 24-year follow up with the participating individuals, from 1986 to 2010. During this period, 12,321 men had a vasectomy, and of these individuals, 6,023 were diagnosed with prostate cancer. Among the prostate cancer diagnoses, 811 were deemed more aggressive and likely to progress to a fatal outcome cases.

The results, published in the Journal of Clinical Oncology, indicated that vasectomy was associated with a 10 percent increased risk of prostate cancer overall with no significant increased risk for low-grade cancer. However, men who had a vasectomy had a stronger risk associated with advanced and lethal prostate cancer, with 20% and 19% increased risk respectively. In addition, researchers were able to discount certain biases, including: men who have vasectomies may seek more medical care in general, that they may have a higher rates of PSA screening, or that the association was due possible confounding by sexually transmitted infections.

The biological basis for associated increase in prostate cancer remains unknown. Dr. James M. McKiernan, interim chairman of the department of urology at Columbia, was critical of this factor, commenting, If someone asked for a vasectomy, I would have to tell them that there is this new data in this regard, but it s not enough for me to change the standard of care. I would not say that you should avoid vasectomy.

Remarks from lead author, Lorelei A. Mucci, associate professor of epidemiology at the Harvard School of Public Health agree with Dr. McKiernan: This is one piece of evidence that should be considered. She adds, Having a vasectomy is a highly personal decision that men should make with their families and discuss with their physicians.