The safety of vasectomy: recent concerns.

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.