The question of whether or not the risk of prostate cancer rises after having a vasectomy may finally have been answered.
Having a vasectomy is an effective, long-term contraceptive method. It is comparatively safer, quicker, and cheaper than the female equivalent: tubal ligation.
This figure accounts for just 3 percent of the married population. Despite the effectiveness and safety of the procedure, many couples do not opt for a vasectomy.
Part of the reason for this may be a 30-year-old debate surrounding its potential link with prostate cancer.
Vasectomy fears hotly debated
In the late 1980s, reports began to emerge of a relationship between this simple procedure and an increased risk of prostate cancer. A number of research teams investigated, and many studies were published that fell on both sides of the argument.
So, in an attempt to make sense of the data behind the discussion, meta-analyses were carried out and released - but even these failed to lay the debate to rest, and the jury remained well and truly out.
Despite there being no plausible medical explanation as to how these two things could be related, the argument continued.
In the latest attempt to end this discussion once and for all, several researchers carried out the largest systematic literature review and meta-analysis to date.
The paper, recently published in JAMA Internal Medicine, included data from 3 million patients across 53 studies.
According to the authors, they paid "particular attention to study quality" and set out "to determine if there is an association between vasectomy and any prostate cancer, high-risk prostate cancer, advanced prostate cancer, and lethal prostate cancer."
Concerns laid to rest?
Once the analysis was complete, the researchers' conclusions were clear. They say that the "review found no association between vasectomy and high-grade, advanced-stage, or fatal prostate cancer."
They add, "There was a weak association between vasectomy and any prostate cancer that was closer to the null with increasingly robust study design."
"This association is unlikely to be causal and should not preclude the use of vasectomy as a long-term contraceptive option."
The "weak association" mentioned above is thought to be due, at least in part, to the so-called cascade effect.
In other words, because a man with a vasectomy has already seen a urologist, he is more likely to return at a later date for prostate-specific antigen testing. And because he is being tested, a diagnosis of prostate cancer becomes more likely.
When talking about the tiny increase in risk that they measured, study co-author Dr. Bimal Bhindi - of the Mayo Clinic in Rochester, MN - says, "It shouldn't stop you from gaining something that is otherwise very effective for family planning purposes."
Also, Dr. Eric A. Klein - chairman of the Cleveland Clinic's Glickman Urological & Kidney Institute in Ohio - says, "This study, involving 3 million patients, is the largest ever conducted. It found no meaningful increased risk of prostate cancer for men who have had a vasectomy."
"The fact that this study found no increased risk of prostate cancer from prior vasectomy should set everyone's mind at ease," he adds.
These findings are important. Between 2006 and 2008, an estimated 10.3 million women in the United States used female sterilization, while just 3.7 million men used male sterilization as their form of contraception.
Because the vasectomy is much safer, it should be recommended to couples seeking long-term contraception. Perhaps these findings will help to put male minds at ease and encourage doctors to offer it as a simpler solution to long-term contraception than female sterilization.
Although this research is wide-ranging and detailed - and the conclusions solid - only time will tell if it is refuted again.