Smith Karl, Castaño Jose Maria, Chirlaque Maria Dolores, Lilja Hans, Agudo Antonio, Ardanaz Eva, Rodríguez-Barranco Miguel, Boeing Heiner, Kaaks Rudolf, Khaw Kay-Tee, Larrañaga Nerea, Navarro Carmen, Olsen Anja, Overvad Kim, Perez-Cornago Aurora, Rohrmann Sabine, Sánchez Maria José, Tjønneland Anne, Tsilidis Konstantinos K, Johansson Mattias, Riboli Elio, Key Timothy J, Travis Ruth C
Karl Smith Byrne, Hans Lilja, Aurora Perez-Cornago, Timothy J. Key, and Ruth C. Travis, University of Oxford, Oxford; Kay-Tee Khaw, School of Clinical Medicine, University of Cambridge, Cambridge, Konstantinos K. Tsilidis and Elio Riboli, Imperial College London, London, United Kingdom; Jose Maria Castaño, Maria Dolores Chirlaque, and Carmen Navarro, Murcia Regional Health Council; Maria Dolores Chirlaque, IMIB-Arrixaca, Murcia; Jose Maria Castaño, Maria Dolores Chirlaque, Eva Ardanaz, Miguel Rodríguez-Barranco, Nerea Larrañaga, Carmen Navarro, and Maria José Sánchez, Center for Biomedical Research Network for Epidemiology and Public Health, Madrid; Antonio Agudo, Catalan Institute of Oncology-IDIBELL, Barcelona, Spain; Eva Ardanaz, Navarra Institute for Health Research, Pamplona; Miguel Rodríguez-Barranco and Maria José Sánchez, Universidad de Granada, Granada; Nerea Larrañaga, Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain; Hans Lilja, Memorial Sloan Kettering Cancer Center, New York, NY; Lund University, Malmö, Sweden; Heiner Boeing, German Institute of Human Nutrition, Potsdam-Rehbrücke; Rudolf Kaaks, German Cancer Research Center, Heidelberg, Germany; Anja Olsen and Anne Tjønneland, Danish Cancer Society Research Center, Copenhagen; Kim Overvad, Aarhus University, Aarhus, Denmark; Sabine Rohrmann, University of Zurich, Zurich, Switzerland; Konstantinos K. Tsilidis, University of Ioannina School of Medicine, Ionnina, Greece, and Mattias Johansson, International Agency for Research on Cancer, Lyon, France.
J Clin Oncol. 2017 Apr 20;35(12):1297-1303. doi: 10.1200/JCO.2016.70.0062. Epub 2017 Mar 6.
Purpose Vasectomy is a commonly used form of male sterilization, and some studies have suggested that it may be associated with an increased risk of prostate cancer, including more aggressive forms of the disease. We investigated the prospective association of vasectomy with prostate cancer in a large European cohort, with a focus on high-grade and advanced-stage tumors, and death due to prostate cancer. Patients and Methods A total of 84,753 men from the European Prospective Investigation into Cancer and Nutrition (EPIC), aged 35 to 79 years, provided information on vasectomy status (15% with vasectomy) at recruitment and were followed for incidence of prostate cancer and death. We estimated the association of vasectomy with prostate cancer risk overall, by tumor subtype, and for death due to prostate cancer, using multivariable-adjusted Cox proportional hazards models. Results During an average follow-up of 15.4 years, 4,377 men were diagnosed with prostate cancer, including 641 who had undergone a vasectomy. Vasectomy was not associated with prostate cancer risk (hazard ratio [HR], 1.05; 95% CI, 0.96 to 1.15), and no evidence for heterogeneity in the association was observed by stage of disease or years since vasectomy. There was some evidence of heterogeneity by tumor grade ( P = .02), with an increased risk for low-intermediate grade (HR, 1.14; 95% CI, 1.01 to 1.29) but not high-grade prostate cancer (HR, 0.83; 95% CI, 0.64 to 1.07). Vasectomy was not associated with death due to prostate cancer (HR, 0.88; 95% CI, 0.68 to 1.12). Conclusion These findings from a large European prospective study show no elevated risk for overall, high-grade or advanced-stage prostate cancer, or death due to prostate cancer in men who have undergone a vasectomy compared with men who have not.
目的 输精管切除术是一种常用的男性绝育方式，一些研究表明，它可能与前列腺癌风险增加有关，包括更具侵袭性的前列腺癌形式。我们在一个大型欧洲队列中研究了输精管切除术与前列腺癌的前瞻性关联，重点关注高级别和晚期肿瘤以及前列腺癌死亡情况。
患者和方法 来自欧洲癌症与营养前瞻性调查（EPIC）的84753名年龄在35至79岁之间的男性在入组时提供了输精管切除术状态信息（15%接受了输精管切除术），并随访前列腺癌发病率和死亡情况。我们使用多变量调整的Cox比例风险模型估计输精管切除术与总体前列腺癌风险、按肿瘤亚型以及前列腺癌死亡的关联。
结果 在平均15.4年的随访期间，4377名男性被诊断患有前列腺癌，其中641名接受了输精管切除术。输精管切除术与前列腺癌风险无关（风险比[HR]，1.05；95%置信区间，0.96至1.15），且未观察到疾病分期或输精管切除术后年限在关联方面存在异质性证据。按肿瘤分级存在一些异质性证据（P = 0.02），低中级分级风险增加（HR，1.14；95%置信区间，1.01至1.29），但高级别前列腺癌风险未增加（HR，0.83；95%置信区间，0.64至1.07）。输精管切除术与前列腺癌死亡无关（HR，0.88；95%置信区间，0.68至1.12）。
结论 这项大型欧洲前瞻性研究的结果表明，与未接受输精管切除术的男性相比，接受输精管切除术的男性总体、高级别或晚期前列腺癌风险或前列腺癌死亡风险并未升高。
