Dataset Information

The Association Between Vasectomy and Prostate Cancer: A Systematic Review and Meta-analysis.

ABSTRACT:

Importance

Despite 3 decades of study, there remains ongoing debate regarding whether vasectomy is associated with prostate cancer.

Objective

To determine if vasectomy is associated with prostate cancer.

Data sources

The MEDLINE, EMBASE, Web of Science, and Scopus databases were searched for studies indexed from database inception to March 21, 2017, without language restriction.

Study selection

Cohort, case-control, and cross-sectional studies reporting relative effect estimates for the association between vasectomy and prostate cancer were included.

Data extraction and synthesis

Two investigators performed study selection independently. Data were pooled separately by study design type using random-effects models. The Newcastle-Ottawa Scale was used to assess risk of bias.

Main outcomes and measures

The primary outcome was any diagnosis of prostate cancer. Secondary outcomes were high-grade, advanced, and fatal prostate cancer.

Results

Fifty-three studies (16 cohort studies including 2?563?519 participants, 33 case-control studies including 44?536 participants, and 4 cross-sectional studies including 12?098?221 participants) were included. Of these, 7 cohort studies (44%), 26 case-control studies (79%), and all 4 cross-sectional studies were deemed to have a moderate to high risk of bias. Among studies deemed to have a low risk of bias, a weak association was found among cohort studies (7 studies; adjusted rate ratio, 1.05; 95% CI, 1.02-1.09; P?Conclusions and relevanceThis review found no association between vasectomy and high-grade, advanced-stage, or fatal prostate cancer. There was a weak association between vasectomy and any prostate cancer that was closer to the null with increasingly robust study design. This association is unlikely to be causal and should not preclude the use of vasectomy as a long-term contraceptive option.

SUBMITTER: Bhindi B

PROVIDER: S-EPMC5710573 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Publications

The Association Between Vasectomy and Prostate Cancer: A Systematic Review and Meta-analysis.

Bhindi Bimal B Wallis Christopher J D CJD Nayan Madhur M Farrell Ann M AM Trost Landon W LW Hamilton Robert J RJ Kulkarni Girish S GS Finelli Antonio A Fleshner Neil E NE Boorjian Stephen A SA Karnes R Jeffrey RJ

JAMA internal medicine 20170901 9

<h4>Importance</h4>Despite 3 decades of study, there remains ongoing debate regarding whether vasectomy is associated with prostate cancer.<h4>Objective</h4>To determine if vasectomy is associated with prostate cancer.<h4>Data sources</h4>The MEDLINE, EMBASE, Web of Science, and Scopus databases were searched for studies indexed from database inception to March 21, 2017, without language restriction.<h4>Study selection</h4>Cohort, case-control, and cross-sectional studies reporting relative effe ...[more]

PMID: 28715534

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Project description:ContextPrevious reports have shown an association between vasectomy and prostate cancer (PCa). However, there exist significant discrepancies between studies and systematic reviews due to a lack of strong causal association and residual confounding factors such as prostate-specific antigen (PSA) screening.ObjectiveTo assess the association between vasectomy and PCa, in both unadjusted and PSA screen-adjusted studies.Evidence acquisitionWe performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. The PubMed, Scopus, and Web of Science databases were searched in January 2022 for studies that analyzed the association between vasectomy and PCa.Evidence synthesisA total of 37 studies including 16 931 805 patients met our inclusion criteria. A pooled analysis from all studies showed a significant association between vasectomy and any-grade PCa (odds ratio [OR] 1.23; 95% confidence interval [CI], 1.10-1.37; p < 0.001; I2 = 96%), localized PCa (OR 1.08; 95% CI, 1.06-1.11; p < 0.00001; I2 = 31%), or advanced PCa (OR 1.07; 95% CI, 1.02-1.13; p = 0.006; I2 = 0%). The association with PCa remained significant when the analyses were restricted to studies with a low risk of bias (OR 1.06; 95% CI, 1.02-1.10; p = 0.02; I2 = 48%) or cohort studies (OR 1.09; 95% CI, 1.04-1.13; p < 0.0001; I2 = 64%). Among studies adjusted for PSA screening, the association with localized PCa (OR 1.06; 95% CI, 1.03-1.09; p < 0.001; I2 = 0%) remained significant. Conversely, vasectomy was no longer associated with localized high-grade (p = 0.19), advanced (p = 0.22), and lethal (p = 0.42) PCa.ConclusionsOur meta-analysis found an association between vasectomy and any, mainly localized, PCa. However, the effect estimates of the association were increasingly close to null when examining studies of robust design and high quality. On exploratory analyses including studies, which adjusted for PSA screening, the association for aggressive and/or advanced PCa diminished.Patient summaryIn this study, we found an association between vasectomy and the risk of developing localized prostate cancer without being able to determine whether the procedure leads to a higher prostate cancer incidence.

Project description:BACKGROUND: Physical activity may protect against bladder cancer through several biologic pathways, such as enhanced immune function and decreased chronic inflammation. Physical activity may also indirectly prevent bladder cancer by reducing obesity. A sizeable number of epidemiologic studies have examined the association between physical activity and bladder cancer, but the available evidence has not yet been formally summarised using meta-analysis. METHODS: We performed a systematic literature review and meta-analysis of English-language studies published from January 1975 through November 2013. We followed the PRISMA guidelines and used a random effects model to estimate the summary risk estimates for the association between physical activity and bladder cancer. RESULTS: A total of 15 studies with 5,402,369 subjects and 27,784 bladder cancer cases were included. High vs low levels of physical activity were related to decreased bladder cancer risk (summary relative risk (RR)=0.85, 95% confidence interval (CI)=0.74-0.98; I(2)=83%; P-value for heterogeneity across all studies<0.001). Results were similar for cohort studies (RR=0.89, 95% CI=0.80-1.00; I(2)=64%) and case-control studies (RR=0.71, 95% CI=0.43-1.16; I(2)=87%; P-value for difference=0.108) and they were comparable for women (RR=0.83, 95% CI=0.73-0.94; I(2)=0%) and men (RR=0.92, 95% CI=0.82-1.05; I(2)=67; P-value for difference=0.657). Findings were also comparable for recreational (RR=0.81, 95% CI=0.66-0.99; I(2)=77%) and occupational physical activity (RR=0.90, 95% CI=0.76-1.0; I(2)=76%; P-value for difference=0.374), and they were largely consistent for moderate (RR=0.85, 95% CI=0.75-0.98; I(2)=76%) and vigorous activity (RR=0.80, 95% CI=0.64-1.00;I(2)=87%; P-value for difference=0.535). CONCLUSIONS: Physical activity is associated with decreased risk of bladder cancer. Further studies are required to assess the relations of intensity, frequency, duration, and timing in life of physical activity to bladder cancer risk.

Dataset Information

The Association Between Vasectomy and Prostate Cancer: A Systematic Review and Meta-analysis.

Importance

Objective

Data sources

Study selection

Data extraction and synthesis

Main outcomes and measures

Results

Publications

The Association Between Vasectomy and Prostate Cancer: A Systematic Review and Meta-analysis.

Similar Datasets

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