PDF(Pubmed)
Abstract：
UNASSIGNED: Previous reports have shown an association between vasectomy and prostate cancer (PCa). However, there exist significant discrepancies between studies and systematic reviews due to a lack of strong causal association and residual confounding factors such as prostate-specific antigen (PSA) screening.
UNASSIGNED: To assess the association between vasectomy and PCa, in both unadjusted and PSA screen-adjusted studies.
UNASSIGNED: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. The PubMed, Scopus, and Web of Science databases were searched in January 2022 for studies that analyzed the association between vasectomy and PCa.
UNASSIGNED: A total of 37 studies including 16 931 805 patients met our inclusion criteria. A pooled analysis from all studies showed a significant association between vasectomy and any-grade PCa (odds ratio [OR] 1.23; 95% confidence interval [CI], 1.10-1.37; p < 0.001; I2 = 96%), localized PCa (OR 1.08; 95% CI, 1.06-1.11; p < 0.00001; I2 = 31%), or advanced PCa (OR 1.07; 95% CI, 1.02-1.13; p = 0.006; I2 = 0%). The association with PCa remained significant when the analyses were restricted to studies with a low risk of bias (OR 1.06; 95% CI, 1.02-1.10; p = 0.02; I2 = 48%) or cohort studies (OR 1.09; 95% CI, 1.04-1.13; p < 0.0001; I2 = 64%). Among studies adjusted for PSA screening, the association with localized PCa (OR 1.06; 95% CI, 1.03-1.09; p < 0.001; I2 = 0%) remained significant. Conversely, vasectomy was no longer associated with localized high-grade (p = 0.19), advanced (p = 0.22), and lethal (p = 0.42) PCa.
UNASSIGNED: Our meta-analysis found an association between vasectomy and any, mainly localized, PCa. However, the effect estimates of the association were increasingly close to null when examining studies of robust design and high quality. On exploratory analyses including studies, which adjusted for PSA screening, the association for aggressive and/or advanced PCa diminished.
UNASSIGNED: In this study, we found an association between vasectomy and the risk of developing localized prostate cancer without being able to determine whether the procedure leads to a higher prostate cancer incidence.
UNASSIGNED: To assess the association between vasectomy and PCa, in both unadjusted and PSA screen-adjusted studies.
UNASSIGNED: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. The PubMed, Scopus, and Web of Science databases were searched in January 2022 for studies that analyzed the association between vasectomy and PCa.
UNASSIGNED: A total of 37 studies including 16 931 805 patients met our inclusion criteria. A pooled analysis from all studies showed a significant association between vasectomy and any-grade PCa (odds ratio [OR] 1.23; 95% confidence interval [CI], 1.10-1.37; p < 0.001; I2 = 96%), localized PCa (OR 1.08; 95% CI, 1.06-1.11; p < 0.00001; I2 = 31%), or advanced PCa (OR 1.07; 95% CI, 1.02-1.13; p = 0.006; I2 = 0%). The association with PCa remained significant when the analyses were restricted to studies with a low risk of bias (OR 1.06; 95% CI, 1.02-1.10; p = 0.02; I2 = 48%) or cohort studies (OR 1.09; 95% CI, 1.04-1.13; p < 0.0001; I2 = 64%). Among studies adjusted for PSA screening, the association with localized PCa (OR 1.06; 95% CI, 1.03-1.09; p < 0.001; I2 = 0%) remained significant. Conversely, vasectomy was no longer associated with localized high-grade (p = 0.19), advanced (p = 0.22), and lethal (p = 0.42) PCa.
UNASSIGNED: Our meta-analysis found an association between vasectomy and any, mainly localized, PCa. However, the effect estimates of the association were increasingly close to null when examining studies of robust design and high quality. On exploratory analyses including studies, which adjusted for PSA screening, the association for aggressive and/or advanced PCa diminished.
UNASSIGNED: In this study, we found an association between vasectomy and the risk of developing localized prostate cancer without being able to determine whether the procedure leads to a higher prostate cancer incidence.
摘要：
■先前的报道显示输精管结扎术与前列腺癌（PCa）之间存在关联。然而,由于缺乏强因果关联和前列腺特异性抗原(PSA)筛查等残留混杂因素,研究与系统综述之间存在显著差异.
■为了评估输精管结扎术和PCa之间的关联，在未调整和PSA屏幕调整的研究中。
■我们根据系统评价和荟萃分析的首选报告项目进行了系统评价。PubMed,Scopus,和WebofScience数据库在2022年1月搜索了分析输精管结扎术和PCa之间关联的研究。
■共有37项研究符合我们的纳入标准，包括16.931.805例患者。所有研究的汇总分析表明，输精管结扎术与任何级别PCa之间存在显着关联（比值比[OR]1.23；95％置信区间[CI]，1.10-1.37；p<0.001；I2=96%），局部PCa(OR1.08；95%CI，1.06-1.11；p<0.00001；I2=31%)，或晚期PCa（OR1.07；95%CI，1.02-1.13；p=0.006；I2=0%）。当分析仅限于低偏倚风险的研究（OR1.06;95％CI，1.02-1.10;p=0.02;I2=48％）或队列研究（OR1.09;95％CI，1.04-1.13;p<0.0001;I2=64％）时，与PCa的相关性仍然显着。在针对PSA筛查进行调整的研究中，与局部PCa的相关性(OR1.06;95%CI,1.03-1.09;p<0.001;I2=0%)仍然显著.相反，输精管结扎不再与局部高级别相关（p=0.19），高级（p=0.22），和致死性(p=0.42)PCa。
■我们的荟萃分析发现输精管结扎术与任何，主要是局部的,PCa。然而,在检查稳健设计和高质量的研究时,该关联的效应估计越来越接近于零.在包括研究在内的探索性分析中，对PSA筛查进行了调整，侵袭性和/或晚期PCa的关联减弱。
■在这项研究中，我们发现输精管结扎术与发生局限性前列腺癌的风险之间存在关联,但我们无法确定该手术是否会导致更高的前列腺癌发病率.
■为了评估输精管结扎术和PCa之间的关联，在未调整和PSA屏幕调整的研究中。
■我们根据系统评价和荟萃分析的首选报告项目进行了系统评价。PubMed,Scopus,和WebofScience数据库在2022年1月搜索了分析输精管结扎术和PCa之间关联的研究。
■共有37项研究符合我们的纳入标准，包括16.931.805例患者。所有研究的汇总分析表明，输精管结扎术与任何级别PCa之间存在显着关联（比值比[OR]1.23；95％置信区间[CI]，1.10-1.37；p<0.001；I2=96%），局部PCa(OR1.08；95%CI，1.06-1.11；p<0.00001；I2=31%)，或晚期PCa（OR1.07；95%CI，1.02-1.13；p=0.006；I2=0%）。当分析仅限于低偏倚风险的研究（OR1.06;95％CI，1.02-1.10;p=0.02;I2=48％）或队列研究（OR1.09;95％CI，1.04-1.13;p<0.0001;I2=64％）时，与PCa的相关性仍然显着。在针对PSA筛查进行调整的研究中，与局部PCa的相关性(OR1.06;95%CI,1.03-1.09;p<0.001;I2=0%)仍然显著.相反，输精管结扎不再与局部高级别相关（p=0.19），高级（p=0.22），和致死性(p=0.42)PCa。
■我们的荟萃分析发现输精管结扎术与任何，主要是局部的,PCa。然而,在检查稳健设计和高质量的研究时,该关联的效应估计越来越接近于零.在包括研究在内的探索性分析中，对PSA筛查进行了调整，侵袭性和/或晚期PCa的关联减弱。
■在这项研究中，我们发现输精管结扎术与发生局限性前列腺癌的风险之间存在关联,但我们无法确定该手术是否会导致更高的前列腺癌发病率.
