Cheng Sheng, Yang Bo, Xu Liwei, Zheng Qiming, Ding Guoqing, Li Gonghui
Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
Department of Urology, Shanghai Zhou Pu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China.
Carcinogenesis. 2021 Feb 11;42(1):31-37. doi: 10.1093/carcin/bgaa086.
Epidemiological cohort studies investigating the association between vasectomy and prostate cancer risk have yielded inconsistent results. The aim of the present meta-analysis is to update the evidence on the association between vasectomy and prostate cancer. A comprehensively literature search of relevant studies was performed in December 2019 using PubMed. A DerSimonian and Laird random-effects model was used to calculate the summary relative risk (RR) and its 95% confidence interval (CI). A total of 15 eligible cohort studies (16 data sets) with more than four million of participants were eventually included in this meta-analysis. There was a statistically significant higher risk of prostate cancer among men who underwent vasectomy (RR: 1.09, 95% CI: 1.04-1.13) with obvious heterogeneity among included studies (P < 0.001, I2 = 64.2%). Vasectomy was also associated with the risk of advanced prostate cancer (RR: 1.07, 95% CI: 1.02-1.13), which is less likely to be affected from detection bias. In conclusion, findings from this meta-analysis of prospective studies indicate that vasectomy may be positively associated with the risk of prostate cancer. Further large prospective studies with long follow-up are warranted to verify the findings from this meta-analysis. In addition, the potential underlying molecular mechanism needed further exploration with in vitro and animal studies.
调查输精管结扎术与前列腺癌风险之间关联的流行病学队列研究结果并不一致。本荟萃分析的目的是更新关于输精管结扎术与前列腺癌关联的证据。2019年12月使用PubMed对相关研究进行了全面的文献检索。采用DerSimonian和Laird随机效应模型计算汇总相对风险（RR）及其95%置信区间（CI）。本荟萃分析最终纳入了15项符合条件的队列研究（16个数据集），参与人数超过400万。接受输精管结扎术的男性患前列腺癌的风险在统计学上显著更高（RR：1.09，95%CI：1.04 - 1.13），纳入研究之间存在明显异质性（P < 0.001，I² = 64.2%）。输精管结扎术还与晚期前列腺癌风险相关（RR：1.07，95%CI：1.02 - 1.13），其受检测偏倚影响的可能性较小。总之，这项前瞻性研究的荟萃分析结果表明，输精管结扎术可能与前列腺癌风险呈正相关。需要进一步开展长期随访的大型前瞻性研究来验证本荟萃分析的结果。此外，潜在的分子机制需要通过体外和动物研究进一步探索。
