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PSA test

Vasectomy is a common form of male sterilization, and some previous studies have suggested that it may be associated with an increased risk of prostate cancer.

A new study led by the Cancer Epidemiology Unit in the Nuffield Department of Population Health, and published in the Journal of Clinical Oncology followed 84,753 men aged between 35 and 79, from Denmark, Germany, Spain, and the UK for up to 15 years. The study, which is part of the European Prospective Investigation into Cancer and Nutrition (EPIC), found no increased risk for overall, high grade or advanced stage prostate cancer or death from prostate cancer in men who have had a vasectomy compared to those who have not. However vasectomy was associated with an increased risk of low-intermediate grade prostate cancer.

Karl Smith-Byrne, the lead author of the study, said “We found no evidence to suggest that vasectomy is associated with an increased risk of prostate cancer overall, high grade or advanced stage disease, or death from prostate cancer. These findings are in line with the lack, to date, of any established biological rationale for vasectomy as a risk factor for prostate cancer.”

At recruitment 15% of the study participants reported having had a vasectomy. Over the 15 year follow-up period 4,377 men were diagnosed with prostate cancer, 641 of these men had had a vasectomy.  By the end of follow up a total of 15,285 men had died, of whom 632 had died of prostate cancer.

Just over 97% of the men in the EPIC-Oxford cohort completed a follow-up questionnaire 10 years after recruitment providing information on their history of PSA testing and age at PSA test. PSA is a blood test for those worried about prostate cancer which measures levels of prostate-specific antigen in the blood and can detect early signs of an enlarged prostate 

Karl Smith-Byrne said “The increased risk of low-intermediate grade prostate cancer in men with a vasectomy might be partly explained by differences in the use of PSA testing; men who have a vasectomy may be more likely to attend health care services, and receive a PSA test, and so also be more likely to be diagnosed with prostate cancer, especially low grade disease.”

Evidence for this hypothesis comes from the finding that in the EPIC-Oxford cohort, men with a vasectomy were more likely to have had a PSA test than men without a vasectomy.