Increases Risk of Fetal Prostate Cancer
had a permanent vasectomy have an increased risk
by 10% of developing prostate cancer, according to a recent study that was conducted
for 24 years on nearly 50,000
men. The correlation relates
particularly aggressive and
deadly forms prostate cancer.
Vasectomy is a surgical procedurethat involves clamping, cutting, or sealing the vas
deferens from each testicle
that carries sperm to the seminal stream (ejaculate) in order to prevent
fertilization from occurring. It is a common
contraception (birth control)
in Anglo-Saxon countries.
According to a recent Statistics released by World Health Organization (WHO), In the
United Kingdom and the United States, the
percentages of men undergone this procedures are about
20% and 13% respectively. In European countries such as
France, this procedure is also common. It is allowed since 2001 to permanently
cutting the vas deferens that carries sperm to the prostate.
explored the eventual connection between sterilization by
vasectomy and the occurrence of prostate cancer. But the results, due to little homogeneity, appear contradictory. But another study Initiated in
1986 by the team of Dr. Lorelei
Mucci (Harvard School of Public
Health, Boston) which included 49,400 men aged 40-75 years has shed more light.
In 2000, 25% of them (the 49,400 men) had
voluntarily undergone a vasectomy for contraceptive purposes.
The Results? Fetal Cases
of Prostate Cancer Increased
At the end of follow-up in
2010, prostate cancer was diagnosed
in 6023 of these 49,400 men
(12.2%). Of these, 732 had a
high grade cancer. A total of 811
cases were fatal. 24-year follow-up,
"the cumulative incidence of serious forms of prostate cancer was 1.6%. Considering the risks, the absolute risk is only
slightly increased after a
vasectomy”, the researchers said.
Of all cases of prostate cancer, men who had a vasectomy have a
10% risk in addition to developing
cancer, compared to those who did not
undergo a permanent contraception.
Vasectomy was specifically
associated with increased risk of
advanced and fatal prostate cancer, with an increase of 20% and 19% respectively.
The risk of high grade cancer, Gleason score 8 to 10, also recorded an increase of 22%.
However, no significant relationship was observed between
vasectomy and the risk of low-grade or localized
score6 is a
low-grade cancer, 7 is a medium-grade cancer, and a score of 8, 9, or 10is a high-grade cancer.
Screening and Prostate Cancer
Additional analysis was performed on a subgroup of nearly 14,000 men who
regularly used a screening
for prostate cancer with Prostate-specific antigen (PSA).
Among these individuals, the risk of high
grade cancer after vasectomy is
even higher, with an increase of 28%. The risk of developing fatal prostate cancer
is also increased, from 19% to
"The correlation between prostate cancer and vasectomy is still observed
in patients screened, the increased risk of
prostate cancer cannot be explained through the diagnosis," said the researchers.
But the increased
risk of cancer could indeed
be related to more frequent screening in
patients opting for vasectomy.
To identify potential risk factors and
explore other ways, the influence of
sex hormones, sexually transmitted infections or type of cancer treatment administered was
assessed. No correlation could be
Importance to Understand
"It is necessary to better understand the potential
underlying mechanisms contributing to increase the risk of the disease after vasectomy", said Dr. David Miler, Department of Urology the University of Michigan, Medscape Medical
News. The risk of prostate cancer
of high grade and fatal evolution are certainly higher after permanent vasectomy, "but it is ultimately an absolute risk for about 1%; this is very low, "said the urologist.
According to Dr. David Miler, given the
contradictions that the study currently presents,
the literature cannot be referred
to discourage men who envisage who consider to undergoing a vasectomy, particularly because of the lack of clarity to identify other potential causes
of the increase.
"The results of this study call for
further research to clarify the
association between prostate cancer and vasectomy," the authors concluded.
Minhaj M, Wilson K, Epstein M, Massoubre C. Vasectomy and risk of aggressive prostate cancer : a 24-year
follow-up study. Journal of Clinical Oncology ; publication en ligne du 7 juillet 2014