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Men who have a vasectomy may be at an increased risk of developing prostate cancer, a new Harvard study suggests.

For the study, researchers analyzed data from more than 49,400 American men who were followed for 24 years. 25 percent of the men in the study who’d had a vasectomy had a 10 percent increased risk of developing aggressive prostate cancer, according to the study published online in the Journal of Clinical Oncology.

Vasectomy was associated with a 20 percent higher risk of advanced prostate cancer and a 19 percent greater risk of fatal prostate cancer, respectively, the study authors said.

Even among men who had regular prostate-specific antigen (PSA) screening tests for prostate cancer, those who had a vasectomy were 56 percent more likely to develop fatal prostate cancer. This link was strongest among men who had a vasectomy at a younger age.

However, the absolute risk of developing deadly prostate cancer was small, the study authors noted — 16 of every 1,000 men.

“This study follows our initial publication on vasectomy and prostate cancer in 1993, with 19 additional years of follow-up and tenfold greater number of cases. The results support the hypothesis that vasectomy is associated with an increased risk of advanced or lethal prostate cancer,” study co-author Lorelei Mucci, associate professor of epidemiology at the Harvard School of Public Health, said in a university news release.

About 15 percent of men in the United States have a vasectomy. Prostate cancer is the second leading cause of death among American men, although most men diagnosed with the disease don’t die from it.