Vasectomy and the risk of prostate cancer: a meta-analysis of cohort studies.
Vasectomy and the risk of prostate cancer: a meta-analysis of cohort studies.
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发表时间：
2015-10
影响因子：
0.1
通讯作者：
Xiao-long Zhang;Jia-jun Yan;Shouhua Pan;Jian-gang Pan;X. Ying;Guan-fu Zhang
中科院分区：
文献类型：
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作者：
Xiao-long Zhang;Jia-jun Yan;Shouhua Pan;Jian-gang Pan;X. Ying;Guan-fu Zhang
背景：输精管结扎术与前列腺癌的关系具有重大的公共卫生意义。然而，观察性研究的结果相互矛盾。为了确定输精管结扎术是否与前列腺癌风险相关，我们对队列研究进行了荟萃分析。方法计算机检索Pubmed、Embase、Cochrane Libraryl、中国国家知识基础设施数据库1966-01/2013-07的相关文献。在荟萃分析之前，使用适当的统计检验来评估研究间的异质性和发表的偏倚。固定效应和随机效应模型用于估计汇总相对危险度(RR)和相应的95%可信区间(CI)。通过Meta回归分析，发现了潜在的异质性来源。同时进行亚组分析和敏感性分析。结果共有9项队列研究参与了分析。这些研究之间存在异质性，但没有发表偏倚。综合结果显示，输精管结扎术与总前列腺癌风险的显著增加无关(RR=1.07，95%CI[0.79，1.46])。当按地理位置对各种研究进行分层时，我们发现在美国进行的研究中，输精管结扎与PCa风险增加之间存在显著关联(RR=1.54，95%CI[1.23，1.93])，然而，在非美国国家进行的研究中，输精管结扎与PCa风险之间没有显著关联(RR=0.74，95%CI[0.50，1.09])。敏感度分析进一步证实了结果的稳定性。结论：目前队列研究的荟萃分析表明，输精管结扎术与前列腺癌风险增加无关。有必要进行更深入的研究，以报告更详细的结果，包括按输精管结扎年龄、肿瘤分级和肿瘤分期分层的结果。
BACKGROUND The relationship of vasectomy to prostate cancer has great public health significance. However, the results of observational studies were conflicting. To determine whether vasectomy is associated with the risk of prostate cancer, we performed a meta-analysis of cohort studies. METHODS A literature search was carried out using Pubmed, Embase, Cochrane Libraryl, and China National Knowledge Infrastructure (CNKI) between January 1966 and July 2013. Before meta-analysis, between-study heterogeneity and publication bias were assessed using adequate statistical tests. Fixed-effect and random-effect models were used to estimate summary relative risks (RR) and the corresponding 95% confidence intervals (CIs). Potential sources of heterogeneity were detected by meta-regression. Subgroup analyses and sensitivity analysis were also performed. RESULTS A total of nine cohort studies contributed to the analysis. There was heterogeneity among the studies but no publication bias. Pooled results indicated that vasectomy was not associated with a significant increase of total prostate cancer risk (RR = 1.07, 95% CI [0.79, 1.46]). When stratified the various studies by geographic location, we found a significant association between vasectomy and increased PCa risk among studies conducted in the USA (RR = 1.54, 95% CI [1.23, 1.93]), however, there was no significant association between vasectomy and PCa risk among studies conducted in non-USA countries (RR = 0.74, 95% CI [0.50, 1.09]). Furthermore, sensitivity analysis confirmed the stability of the results. CONCLUSIONS In conclusion, the present meta-analysis of cohort studies suggested that vasectomy was not associated with increased risk of prostate cancer. More in-depth studies are warranted to report more detailed results, including stratified results by age at vasectomy, tumor grade, and tumor stage.