International Journal of Epidemiology, Vol 26, 933-938, Copyright © 1997 by International Epidemiological Association
EA Platz, BB Yeole, E Cho, DJ Jussawalla, E Giovannucci and A Ascherio
BACKGROUND: The role of vasectomy in the development of prostate cancer
remains controversial. In particular, there has been concern about
detection bias and confounding in the previously published epidemiological
studies examining this hypothesis. With the goal of minimizing detection
bias, we have evaluated the relation between vasectomy and prostate cancer
in a population without routine prostate cancer screening. METHODS: A
case-control study consisting of 175 prostate cancer cases and 978 controls
with cancer diagnoses other than prostate cancer was conducted at hospitals
covered by the Bombay Cancer Registry in Bombay, India. History of
vasectomy, demographic, and lifestyle factors were obtained by structured
interview. Multiple logistic regression was used to estimate odds ratios
(OR) and 95% confidence intervals (CI). RESULTS: Standardizing by age, 8.7%
of cases and 8.3% of controls had had a vasectomy. The OR for prostate
cancer comparing men who had had a vasectomy to those who did not was 1.48
(95% CI: 0.80-2.72) controlling for age at diagnosis, smoking status,
alcohol drinking, and other demographic and lifestyle factors. Risk of
prostate cancer associated with vasectomy appeared to be higher among men
who underwent vasectomy at least two decades prior to cancer diagnosis or
who were at least 40 years old at vasectomy. CONCLUSIONS: Although not
statistically significant, the results of this hospital- based case-control
study are consistent with the hypothesis of a positive association between
vasectomy and prostate cancer. Because routine prostate cancer screening is
not common in this population, detection bias was unlikely to account for
this association.
ARTICLES
Vasectomy and prostate cancer: a case-control study in India
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
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