Objective: To determine whether vasectomy is associated with an increased risk of several diseases, and in particular testicular cancer, after operation.
Design: Retrospective cohort study using linked medical record abstracts.
Setting: Six health districts in Oxford region.
Subjects: 13,246 men aged 25-49 years who had undergone vasectomy between 1970 and 1986, and 22,196 comparison subjects who had been admitted during the same period for one of three specified elective operations, appendicitis, or injuries.
Main outcome measures: Hospital admission and death after vasectomy or comparison event.
Results: The mean durations of follow up were 6.6 years for men with a vasectomy and 7.5 years for men with a comparison condition. The relative risk of cancer of the testis in the vasectomy cohort (4 cases) compared with that in the other cohorts (17 cases) was 0.46 (95% confidence interval 0.1 to 1.4), that of cancer of the prostate (1 v 5 cases) 0.44 (0.1 to 4.0), and that of myocardial infarction (97 v 226 cases) 1.00 (0.8 to 1.3). There was no evidence of an increase associated with vasectomy in the incidence of a range of other diseases.
Conclusions: Vasectomy was not associated with an increased risk of testicular cancer or the other diseases studied. With respect to prostatic cancer, while we found no cause for concern, longer periods of observation on large numbers of men are required.
PIP: An attempt to determine whether vasectomy is associated with an increased risk of diseases, in particular testicular cancer, following surgery, is discussed. 6 health districts in the Oxford region were the site for this retrospective cohort study which used linked medical record abstracts and which evaluated 13,246 men ages 25-49 years who had undergone vasectomy between 1970-86. There were 22,196 controls who were admitted during the same time period for 1 of 3 specified elective surgeries, appendicitis, or injury. The mean durations for followup were 6.6 years for men with vasectomy and 7.5 years for those with a comparison condition. The relative risk of cancer of the testis in the vasectomy cohort (4 cases) compared with that in other cohorts (17 cases) was .46 (95% confidence interval .1-1.4), that of cancer of the prostate (1 of 5 cases) .44 (.1-4.0), and that of myocardial infarction (97 of 226 cases) 1.00 (.8-1.3). There was no evidence of an increase associated with vasectomy in the incidence of a range of other diseases. Vasectomy was thus not associated with an increased risk of testicular cancer or other diseases studied. With regard to prostate cancer, while there was no cause for concern found, longer periods of observation on large numbers of men are necessary.