Vasectomy and Prostate Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC)

Abstract

PurposeVasectomy is a commonly used form of male sterilization, and some studies have suggested that it may be associated with an increased risk of prostate cancer, including more aggressive forms of the disease. We investigated the prospective association of vasectomy with prostate cancer in a large European cohort, with a focus on high-grade and advanced-stage tumors, and death due to prostate cancer.Patients and MethodsA total of 84,753 men from the European Prospective Investigation into Cancer and Nutrition (EPIC), aged 35 to 79 years, provided information on vasectomy status (15% with vasectomy) at recruitment and were followed for incidence of prostate cancer and death. We estimated the association of vasectomy with prostate cancer risk overall, by tumor subtype, and for death due to prostate cancer, using multivariable-adjusted Cox proportional hazards models.ResultsDuring an average follow-up of 15.4 years, 4,377 men were diagnosed with prostate cancer, including 641 who had undergone a vasectomy. Vasectomy was not associated with prostate cancer risk (hazard ratio [HR], 1.05; 95% CI, 0.96 to 1.15), and no evidence for heterogeneity in the association was observed by stage of disease or years since vasectomy. There was some evidence of heterogeneity by tumor grade (P = .02), with an increased risk for low-intermediate grade (HR, 1.14; 95% CI, 1.01 to 1.29) but not high-grade prostate cancer (HR, 0.83; 95% CI, 0.64 to 1.07). Vasectomy was not associated with death due to prostate cancer (HR, 0.88; 95% CI, 0.68 to 1.12).ConclusionThese findings from a large European prospective study show no elevated risk for overall, high-grade or advanced-stage prostate cancer, or death due to prostate cancer in men who have undergone a vasectomy compared with men who have not.

Prospective investigation of risk factors for prostate cancer in the UK Biobank cohort study

“…In agreement with previous studies ( Byrne et al , 2017 ; Nayan et al , 2016 ), we found no association between vasectomy status and prostate cancer risk. In the current study, hypertension was not linked to prostate cancer risk, although there was some evidence that it was associated with an increased risk in the first 2 years of follow-up.…”

Latest Evidence on the Impact of Smoking, Sports, and Sexual Activity as Modifiable Lifestyle Risk Factors for Prostate Cancer Incidence, Recurrence, and Progression: A Systematic Review of the Literature by the European Association of Urology Section of Oncological Urology (ESOU)

“…Vasectomy has been discussed as a putative risk factor for PCa development over recent decades, and some studies have supported an association with lethal PCa [100]. On the contrary, most recent studies found either no or only a weak association between vasectomy and overall PCa risk (closer to the null with increasingly robust study design) and no significant association with HGPCA, advanced-stage PCa, or fatal PCa, finally resulting in currently strong evidence rebutting a relationship between vasectomy and PCa [101][102][103][104][105].…”

“…Smoking results in increased prostatic tissue inflammation [104]. Chronic prostatic inflammation is associated with the presence of proinflammatory cytokines, inflammatory mediators, and growth factors that may lead to uncontrolled proliferative response [13,[86][87][88] Changes in sex steroid pathway Smoking may alter testosterone secretion or inhibit aromatase, resulting in higher concentrations of free and total testosterone; higher daily numbers of cigarettes and PY are also associated with greater concentrations of estradiol [57,89].…”

Vasectomy and the risk of prostate cancer in a prospective US Cohort: Data from the NIH‐AARP Diet and Health Study

“…Most recently, Smith Byrne et al utilized the European Prospective Investigation into Cancer and Nutrition and overall found no association between vasectomy and prostate cancer. (Smith et al, 2017). However, they did identify some heterogeneity in the analysis with a higher risk for low-grade but not high-grade disease.…”

“…The discussion was reignited in 2014 when a prospective cohort study found an association between a history of vasectomy and an increased risk of both overall prostate cancer and high-risk prostate cancer. (Smith et al, 2017). Contemporary studies have contested any association between prior vasectomy and the risk of developing prostate cancer; however, prior cohorts were not without some limitations.…”