Vasectomies are associated with minimal risk of prostate cancer (PCa), according to a new systematic review and meta-analysis.

“We have demonstrated that any risk, if present, is sufficiently small that it is unlikely to be of clinical importance,” a team led by R. Jeffrey Karnes, MD, of Mayo Clinic in Rochester, Minnestoa, reported online in JAMA Internal Medicine. “We believe that this meta-analysis, drawing on 3 decades of epidemiologic literature, provides sufficiently robust data to inform clinical care and supports the current guidelines of the American Urological Association.”

The review and meta-analysis included 53 studies (16 cohort study involving 2,563,519 men, 33 case-control studies involving 44,536 men, and 4 cross-sectional studies involving 12,098,221 men). The researchers found no significant association between vasectomy and high-grade (Gleason score 8 or higher), advanced (typically T3–4, positive nodes, or metastasis), or fatal PCa.

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When the researchers analyzed data from 7 cohort studies and 6 case-control studies that were deemed to have a low risk of bias based on the Newcastle-Ottawa Scale, they found a weak but significant 5% increased risk of PCa in the cohort studies and a similar but a nonsignificant 6% greater odds of PCa in the 6 case-control studies.

The investigators calculated that the absolute increase in lifetime risk of PCa associated with vasectomy was just 0.6% and that vasectomy would be responsible for only 0.5% of PCa cases in the population.

“At most, there is a trivial association between vasectomy and prostate cancer that is unlikely to be causal; therefore, concerns about prostate cancer should not preclude the use of vasectomy as an option for long-term contraception,” Dr Karnes and colleagues concluded.

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Bhindi B, Wallis CJD, Nayan M, et al. The Association Between Vasectomy and Prostate Cancer A Systematic Review and Meta-analysis. JAMA Intern Med. doi:10.1001/jamainternmed.2017.2791