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February 17, 1993, Vol 269, No. 7 >
ARTICLE | February 17, 1993

Vasectomy and Prostate Cancer: Title and subTitle BreakChance, Bias, or a Causal Relationship? FREE

Stuart S. Howards, MD; Herbert B. Peterson, MD
[+] Author Affiliations

Reprint requests to Department of Urology, University of Virginia Health Sciences Center, Box 422, Charlottesville, VA 22908 (Dr Howards).


JAMA. 1993;269(7):913-914. doi:10.1001/jama.1993.03500070093036
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References

This issue of The Journal includes two reports of cohort studies by Giovannucci et al that find an association between vasectomy and subsequent risk of prostate cancer.1,2 Both vasectomy and prostate cancer are common and any causal relationship between the two would be important both for individual and public health. Although the studies by Giovannucci et al are of high quality, whether the relationship they report on is causal remains unclear.

The age-adjusted relative risks for prostate cancer among men with vasectomy in the Nurses' Health Study and the Health Professionals Follow-up Study were 1.56 (95% confidence interval, 1.03 to 2.37) and 1.66 (95% confidence interval, 1.25 to 2.21), respectively. When risk estimates of this magnitude are derived from observational studies, they are considered to be weak associations that may be due to chance, bias, or a causal relationship.3 It is our

See also pp 873 and 878.

REFERENCES

1 +
Giovannucci E, Ascherio A, Rimm E, Colditz GA, Stampfer MJ, Willett WC.  A prospective cohort study of vasectomy and prostate cancer in US men. JAMA . 1993;; 269:873-877.
2 +
Giovannucci E, Tosteson TD, Speizer FE, Ascherio A, Vessey MP, Colditz GA.  A retrospective cohort study of vasectomy and prostate cancer in US men. JAMA . 1993;;269:878-882.
3 +
American Health Foundation.  Conference report: weak associations in epidemiology and their interpretation. Prev Med . 1982;;11:464-476.
4 +
Giovannucci E, Tosteson TD, Speizer FE, Vessey MP, Colditz GA.  A long-term study of mortality in men who have undergone vasectomy. N Engl J Med . 1992;;326: 1392-1398.
5 +
Feinleib M.  Biases and weak associations. Prev Med . 1987;;16:150-164.
6 +
Guess HA.  Invited commentary: vasectomy and prostate cancer. Am J Epidemiol . 1990;;132:1062-1065.
7 +
Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service . Washington, DC: US Dept of Health, Education, and Welfare; 1964;. Public Health Service publication 1103.
8 +
Sidney S, Quesenberry CP Jr, Sadler MC, Guess HA, Lydick EG, Cattolica EV.  Vasectomy and the risk of prostate cancer in a cohort of multiphasic health-checkup examinees: second report. Cancer Causes Control . 1991;;2:113-116.
9 +
Nienhuis H, Goldacre M, Seagroatt V, Gill L, Vessey M.  Incidence of disease after vasectomy: a record linkage retrospective cohort study. BMJ . 1992;;304:743-746.
10 +
Perlman JA, Spirtas R, Kelaghan J, Madans J, Cox C, Kleinman J.  Vasectomy and the risk of prostate cancer. Am J Epidemiol . 1991;;134:107-108.
11 +
Massey FJ, Bernstein GS, O'Fallon WM, et al.  Vasectomy and health: results from a large cohort study. JAMA . 1984;;252:1023-1029.
12 +
Alexander NJ, Wilson BJ, Patterson BD.  Vasectomy: immunological effects on rhesus monkeys and men. Fertil Steril . 1979;;32:253-260.
13 +
Peterson HB, Huber DH, Belker AM.  Vasectomy: an appraisal for the obstetrician and gynecologist. Obstet Gynecol . 1990;;76:568-572.
14 +
Clarkson TB, Alexander NJ, Morgan TM.  Atherosclerosis of cynomolgus monkeys hyper and hyporesponsive to dietary cholesterol: lack of effect of vasectomy. Arteriosclerosis . 1988;;8:488-498.
15 +
 Vasectomy and cancer. Lancet . 1991;;338:1586. Noticeboard.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Giovannucci E, Ascherio A, Rimm E, Colditz GA, Stampfer MJ, Willett WC.  A prospective cohort study of vasectomy and prostate cancer in US men. JAMA . 1993;; 269:873-877.
2 +
Giovannucci E, Tosteson TD, Speizer FE, Ascherio A, Vessey MP, Colditz GA.  A retrospective cohort study of vasectomy and prostate cancer in US men. JAMA . 1993;;269:878-882.
3 +
American Health Foundation.  Conference report: weak associations in epidemiology and their interpretation. Prev Med . 1982;;11:464-476.
4 +
Giovannucci E, Tosteson TD, Speizer FE, Vessey MP, Colditz GA.  A long-term study of mortality in men who have undergone vasectomy. N Engl J Med . 1992;;326: 1392-1398.
5 +
Feinleib M.  Biases and weak associations. Prev Med . 1987;;16:150-164.
6 +
Guess HA.  Invited commentary: vasectomy and prostate cancer. Am J Epidemiol . 1990;;132:1062-1065.
7 +
Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service . Washington, DC: US Dept of Health, Education, and Welfare; 1964;. Public Health Service publication 1103.
8 +
Sidney S, Quesenberry CP Jr, Sadler MC, Guess HA, Lydick EG, Cattolica EV.  Vasectomy and the risk of prostate cancer in a cohort of multiphasic health-checkup examinees: second report. Cancer Causes Control . 1991;;2:113-116.
9 +
Nienhuis H, Goldacre M, Seagroatt V, Gill L, Vessey M.  Incidence of disease after vasectomy: a record linkage retrospective cohort study. BMJ . 1992;;304:743-746.
10 +
Perlman JA, Spirtas R, Kelaghan J, Madans J, Cox C, Kleinman J.  Vasectomy and the risk of prostate cancer. Am J Epidemiol . 1991;;134:107-108.
11 +
Massey FJ, Bernstein GS, O'Fallon WM, et al.  Vasectomy and health: results from a large cohort study. JAMA . 1984;;252:1023-1029.
12 +
Alexander NJ, Wilson BJ, Patterson BD.  Vasectomy: immunological effects on rhesus monkeys and men. Fertil Steril . 1979;;32:253-260.
13 +
Peterson HB, Huber DH, Belker AM.  Vasectomy: an appraisal for the obstetrician and gynecologist. Obstet Gynecol . 1990;;76:568-572.
14 +
Clarkson TB, Alexander NJ, Morgan TM.  Atherosclerosis of cynomolgus monkeys hyper and hyporesponsive to dietary cholesterol: lack of effect of vasectomy. Arteriosclerosis . 1988;;8:488-498.
15 +
 Vasectomy and cancer. Lancet . 1991;;338:1586. Noticeboard.

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