Peng Yunhua, Wang Xingxiu, Feng Huiqin, Yan Ge
Department of Gynecology and Obstetrics, Lanzhou University First Hospital, Lanzhou, Gansu, China.
Oncology Department, Lanzhou Petrochemical General Hospital, Lanzhou, Gansu, China.
J Obstet Gynaecol Res. 2017 May;43(5):913-922. doi: 10.1111/jog.13291.
The purpose of this meta-analysis is to synthesize evidence-based case-control studies to evaluate the association between oral contraceptive (OC) use and the risk of cervical cancer.
Two reviewers independently selected potentially relevant studies through PubMed, Embase, Chinese National Knowledge Infrastructure, Wanfang Data, and the Chongqing VIP databases using the core terms cervical intraepithelial neoplasia/ cervix dysplasia/ cervi* AND oral contraceptive in the article titles, abstracts, and keywords. All data were analyzed using stata 12.0. The heterogeneity was assessed by Q-test and I statistic. Forest plot was used to display results graphically. Publication bias was assessed by Begg's test.
In total, 16 case-control studies, including 15 619 participants (7433 cases and 8186 controls), met the eligibility criteria. Individuals with OC use were not found to have a risk of cervical cancer (odds ratio [OR], 1.12; 95% confidence interval [CI], 0.90-1.38). In subgroup analyses, no significant associations were found for different durations of OC use (<5 years: OR, 0.84; 95%CI, 0.68-1.04; 5-10 years: OR, 1.06; 95%CI, 0.66-1.71; >10 years: OR, 1.25; 95%CI, 0.76-2.06). Additionally, using OC was not shown to increase the risk of cervical cancer among women with human papillomavirus infections (OR, 1.09; 95%CI, 0.80-1.49). However, an increased risk of cervical cancer was found in Asian populations with OC use.
The meta-analysis of case-control studies did not show an association between OC use and risk of cervical cancer. However, other necessary prospective cohort studies should be conducted to assess the impact of OC use on cervical cancer risk in the future.
本荟萃分析旨在综合基于证据的病例对照研究，以评估口服避孕药（OC）使用与宫颈癌风险之间的关联。
两名研究者通过PubMed、Embase、中国知网、万方数据和重庆维普数据库，使用文章标题、摘要和关键词中的核心术语“宫颈上皮内瘤变/宫颈发育异常/宫颈*”和“口服避孕药”，独立筛选潜在相关研究。所有数据均使用Stata 12.0进行分析。通过Q检验和I统计量评估异质性。森林图用于以图形方式展示结果。通过Begg检验评估发表偏倚。
总共16项病例对照研究，包括15619名参与者（7433例病例和8186名对照）符合纳入标准。未发现使用OC的个体有患宫颈癌的风险（比值比[OR]，1.12；95%置信区间[CI]，0.90 - 1.38）。在亚组分析中，不同OC使用时长未发现显著关联（<5年：OR，0.84；95%CI，0.68 - 1.04；5 - 10年：OR，1.06；95%CI，0.66 - 1.71；>10年：OR，1.25；95%CI，0.76 - 2.06）。此外，在感染人乳头瘤病毒的女性中，使用OC未显示会增加患宫颈癌风险（OR，1.09；95%CI，0.80 - 1.49）。然而，在使用OC的亚洲人群中发现患宫颈癌风险增加。
病例对照研究的荟萃分析未显示OC使用与宫颈癌风险之间存在关联。然而，未来应进行其他必要的前瞻性队列研究，以评估OC使用对宫颈癌风险的影响。
