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前列腺癌与输精管切除术:在中国、尼泊尔和大韩民国开展的一项基于医院的病例对照研究。

Prostate cancer and vasectomy: a hospital-based case-control study in China, Nepal and the Republic of Korea.

作者信息

Schwingl Pamela J, Meirik Olav, Kapp Nathalie, Farley Timothy M M

机构信息

Family Health International, Research Triangle Park, NC 27709, USA.

出版信息

Contraception. 2009 May;79(5):363-8. doi: 10.1016/j.contraception.2008.11.015. Epub 2009 Feb 24.

Abstract

BACKGROUND

The study of a possible relationship between vasectomy and prostate cancer has yielded mixed results. Data from developing countries are limited.

STUDY DESIGN

We conducted a hospital-based case-control study in China, Nepal and the Republic of Korea to evaluate the risk of prostate cancer after vasectomy.

RESULTS

Prostate cancer in 294 cases (confirmed by independent pathologists) and 879 matched controls were included. The odds ratio of prostate cancer in men with a history of vasectomy was 1.21 [95% confidence interval (95% CI)=0.79, 1.87]. No significant trend was observed in risk by time since vasectomy or age at vasectomy. The odds ratio for localized disease was 1.02 (95% CI=0.53, 1.95); the odds ratio for later stages was 1.41 (95% CI=0.78, 2.53). No confounding factor was identified. The study illustrated differential misclassification of disease by vasectomy status; reference pathologists determined that 28% of men with a history of vasectomy, compared with 17% of men without a history of vasectomy, were misdiagnosed with prostate cancer by local pathologists.

CONCLUSION

Vasectomy is not associated with an increased risk of prostate cancer in developing countries where the rate of the disease is low.

摘要

背景

关于输精管切除术与前列腺癌之间可能存在的关系的研究结果不一。来自发展中国家的数据有限。

研究设计

我们在中国、尼泊尔和韩国开展了一项基于医院的病例对照研究,以评估输精管切除术后患前列腺癌的风险。

结果

纳入了294例前列腺癌病例(由独立病理学家确诊)和879例匹配对照。有输精管切除术史的男性患前列腺癌的比值比为1.21[95%置信区间(95%CI)=0.79,1.87]。未观察到自输精管切除术后的时间或输精管切除术时的年龄与风险之间存在显著趋势。局限性疾病的比值比为1.02(95%CI=0.53,1.95);晚期疾病的比值比为1.41(95%CI=0.78,2.53)。未发现混杂因素。该研究表明,根据输精管切除术状态对疾病存在不同程度的错误分类;参考病理学家确定,与无输精管切除术史的男性中的17%相比,有输精管切除术史的男性中有28%被当地病理学家误诊为前列腺癌。

结论

在疾病发病率较低的发展中国家,输精管切除术与前列腺癌风险增加无关。

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