Farley T M, Meirik O, Mehta S, Waites G M
Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland.
Bull World Health Organ. 1993;71(3-4):413-9.
Vasectomy has been accepted for family planning by approximately 42 million couples worldwide, the majority of whom live in developing countries. It is a highly reliable and safe contraceptive method, which has been extensively studied. Recently, however, renewed concerns have been raised about a possible effect between vasectomy and cancer of the prostate many years after the procedure has been performed. These concerns are based on research conducted in the USA, where there is a high and rising incidence of prostate cancer. This review discusses the evidence for this association and its potential impact in developing countries. The factors influencing the development and growth of prostate cancer are poorly understood and complicate any research into risk factors for the disease. Overall incidences of prostate cancer in some developed countries, such as the USA, are fifty times higher than in some developing countries, such as China. The majority of epidemiological studies on the relationship between vasectomy and prostate cancer have been based in the USA, but the findings are inconsistent and the reported associations weak. On the basis of currently available data, no changes in family planning policies with regard to vasectomy are warranted, but the concerns raised by these studies require that research into any possible association be undertaken in developing countries where vasectomy is widely practised.
全世界约有4200万对夫妇接受输精管切除术用于计划生育，其中大多数生活在发展中国家。这是一种高度可靠且安全的避孕方法，已经得到广泛研究。然而，最近人们再次对输精管切除术后多年可能出现的输精管切除术与前列腺癌之间的关联表示担忧。这些担忧基于在美国开展的研究，美国前列腺癌的发病率很高且呈上升趋势。本综述讨论了这种关联的证据及其在发展中国家的潜在影响。前列腺癌发生和发展的影响因素尚不清楚，这使得对该疾病风险因素的任何研究都变得复杂。在一些发达国家，如美国，前列腺癌的总体发病率比一些发展中国家，如中国，高出50倍。关于输精管切除术与前列腺癌之间关系的大多数流行病学研究都以美国为基础，但研究结果并不一致，所报告的关联也很微弱。根据现有数据，没有必要改变关于输精管切除术的计划生育政策，但这些研究引发的担忧要求在广泛实施输精管切除术的发展中国家对任何可能的关联进行研究。
