A LONG-TERM STUDY OF MORTALITY IN MEN WHO HAVE UNDERGONE VASECTOMY

被引:51
作者
GIOVANNUCCI, E
TOSTESON, TD
SPEIZER, FE
VESSEY, MP
COLDITZ, GA
机构
[1] BRIGHAM & WOMENS HOSP,BOSTON,MA 02115
[2] UNIV OXFORD,DEPT PUBL HLTH & PRIMARY CARE,OXFORD,ENGLAND
关键词
D O I
10.1056/NEJM199205213262104
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Vasectomy is a reliable and widely accepted method of contraception, but there is some uncertainty and few data about a possible long-term adverse effect on health. Methods. We examined the relation between vasectomy and mortality rates from cardiovascular disease, cancer, and all causes in a retrospective cohort of husbands of members of the Nurses' Health Study. In 1989 we obtained data by questionnaire on 14,607 men who had undergone vasectomy as of 1976 and 14,607 men who had not. Results. Among the men who were free of cancer at the start of the study, 1052 died: 446 of cardiovascular disease, 341 of cancer, and 265 of other causes. Vasectomy was associated with reductions in mortality from all causes (age-adjusted relative risk, 0.85; 95 percent confidence interval, 0.76 to 0.96) and mortality from cardiovascular disease (relative risk, 0.76; 95 percent confidence interval, 0.63 to 0.92). Vasectomy was unrelated to mortality from all forms of cancer (relative risk, 1.01; 95 percent confidence interval, 0.82 to 1.25). Among men who had a vasectomy at least 20 years earlier, the procedure had no relation to mortality from all causes (relative risk, 1.11; 95 percent confidence interval, 0.92 to 1.33) or that from cardiovascular disease (relative risk, 0.85; 95 percent confidence interval, 0.63 to 1.16). However, mortality from cancer was increased in men who had a vasectomy at least 20 years earlier (relative risk, 1.44; 95 percent confidence interval, 1.07 to 1.92). The excess risk of cancer in these men was due primarily to lung cancer. None of the observed associations were confounded by smoking habits, body-mass index, alcohol consumption, or educational level. Conclusions. Vasectomy is not associated with an increase in overall mortality or mortality from cardiovascular disease. Our study also found no increase in overall mortality from cancer after vasectomy, but there was an apparent increase in the risk of cancer 20 or more years after vasectomy that requires further study.
引用
收藏
页码:1392 / 1398
页数:7
相关论文
共 44 条
[1]   EVALUATION OF BLOOD-PRESSURE IN VASECTOMIZED AND NON-VASECTOMIZED MEN [J].
ALEXANDER, NJ ;
SENNER, JW ;
HOCH, EJ .
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 1981, 10 (03) :217-222
[2]   VASECTOMY INCREASES SEVERITY OF DIET-INDUCED ATHEROSCLEROSIS IN MACACA-FASCICULARIS [J].
ALEXANDER, NJ ;
CLARKSON, TB .
SCIENCE, 1978, 201 (4355) :538-541
[3]  
ANDERSON DJ, 1982, J NATL CANCER I, V69, P551
[4]  
ANDERSON DJ, 1983, AM J PATHOL, V111, P129
[5]  
ANSBACHE.R, 1972, FERTIL STERIL, V23, P640
[6]  
ANSBACHER R, 1981, FERTIL STERIL, V36, P222
[7]   DOES VASECTOMY ACCELERATE TESTICULAR-TUMOR - IMPORTANCE OF TESTICULAR EXAMINATIONS BEFORE AND AFTER VASECTOMY [J].
CALE, ARJ ;
FAROUK, M ;
PRESCOTT, RJ ;
WALLACE, IWJ .
BRITISH MEDICAL JOURNAL, 1990, 300 (6721) :370-370
[8]   VASECTOMY AND ATHEROSCLEROSIS - AN ASSOCIATION IN MAN [J].
CAMPBELL, WB ;
SLACK, RWT ;
CLIFFORD, PC ;
SMITH, PJB ;
BAIRD, RN .
BRITISH JOURNAL OF UROLOGY, 1983, 55 (04) :430-433
[9]  
CASTRO JE, 1974, CANCER RES, V34, P2055
[10]   VASECTOMY AND CARDIOVASCULAR DEATHS IN KOREAN MEN - A COMMUNITY-BASED CASE-CONTROL STUDY [J].
CHI, IC ;
KONG, SK ;
WILKENS, LR ;
CHO, AJ ;
SIEMENS, AJ ;
MENG, KH ;
HIGGINS, JE .
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 1990, 19 (04) :1113-1115