As comedian Benny Ross has stated "the inventor of vasectomies must of been a prison warden...who else would prevent these rambunctious little swimmers from getting to their destination."
Humour aside, vasectomies are no laughing matter.
Experts not directly involved in the two large studies on vasectomies call the research scientifically well designed, adding that they underscore the need for further research to assess the possible hazards of one of the most effective and ...widely used methods of contraception.
The studies found that men who had a vasectomy more than 20 years earlier faced up to an 89 percent greater risk of prostate cancer than men who had not had a vasectomy. The studies also found that the more time that had passed since a vasectomy, the greater was the risk of developing prostate cancer.
The studies, reported in The Journal of the American Medical Association, were largely financed by the National Institutes of Health. They were conducted by a team headed by Dr. Edward Giovannucci from the Brigham and Women's Hospital and Harvard University in Boston.
In 1990, a small study from Edinburgh, Scotland, found that an unexpectedly large number of men who had had vesectomies later developed testicular cancer.
Experts said the findings show a statistical association that required further study. No plausible biological cause for the association is yet evident. They speculated that such a biological mechanism might be related to the decreased amount of prostate fluid after a vasectomy or to suppression of immune reactions that affect cancer. The experts also noted that the studies might have been influenced by other non-detectable factors.
The editorial urged men who have had a vasectomy to undergo annual checkups for prostate cancer, which is the recommendation made by the urological group and the American Cancer Society for men 50 to 70 years old.
Doctors should inform men seeking a vasectomy about the new findings, the editorial said.
The World Health Organization, a United Nations agency based in Geneva, said the studies were not definitive but "of high scientific quality" and that the scientific design of the studies avoided many of the methodological problems of earlier studies, some of which did not find a link between vasectomy and prostate cancer.
Experts in the United States and at the W.H.O. said that additional studies were urgently needed because confirmation of the latest findings would have a critical effect on family planning programs. Crucial information could come from at least six ongoing studies in the United States and Europe, the W.H.O. said.
Indications of a link between vasectomy and prostate cancer from recent studies led the World Health Organization to convene a committee of 23 experts from 10 countries in 1991. They concluded that no changes in family planning policies concerning vasectomies were justified on the basis of the biological and epidemiological evidence available then.
W.H.O. officials said that they did not know why reports from the meeting had not been published, as it had been announced they would be, in The European Journal of Cancer.
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