Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rua Marechal Deodoro, Pelotas, Brazil.
Nutr Cancer. 2021;73(1):62-74. doi: 10.1080/01635581.2020.1737151. Epub 2020 Mar 11.
We conducted a meta-analysis to examine the association of fruits and vegetables intake with the occurrence of cervical intraepithelial neoplasia (CIN) and invasive cancer. MEDLINE, LILACS, Scopus, Cochrane Library, and Web of Science databases and gray literature on Google Scholar were searched before December 17, 2018. Odds ratio (OR) or relative risk (RR) estimates for the highest vs. the lowest intake of intake and 95% confidence intervals (CI) from the included studies were pooled using fixed and random-effects models. We found 18 studies: 17 case-control studies ( = 9,014 cases, = 29,088 controls) and one cohort study ( = 299,651). No association was observed for CIN. The pooled adjusted ORs (95% CI) for cervical cancer were 0.61 (95% CI 0.52-0.73) for vegetables and 0.80 (95% CI 0.70-0.93) for fruits. However, no association was observed when the pooled effect was estimated among studies that adjusted for human papillomavirus (HPV). Consumption of vegetables and fruits was not associated with incidence of cervical cancer among studies that controlled for HPV infection. The level of evidence is limited because only one cohort study was included in the analysis.
我们进行了一项荟萃分析，以研究水果和蔬菜摄入量与宫颈上皮内瘤变（CIN）和浸润性癌症发生的关系。在 2018 年 12 月 17 日之前，我们检索了 MEDLINE、LILACS、Scopus、Cochrane 图书馆和 Web of Science 数据库以及 Google Scholar 上的灰色文献。使用固定效应模型和随机效应模型汇总了纳入研究中最高与最低摄入量之间的比值比（OR）或相对风险（RR）估计值以及 95%置信区间（CI）。我们发现了 18 项研究：17 项病例对照研究（ = 9014 例， = 29088 例对照）和一项队列研究（ = 299651 例）。未观察到 CIN 之间存在相关性。蔬菜的调整后 OR（95% CI）为 0.61（95% CI 0.52-0.73），水果为 0.80（95% CI 0.70-0.93）。然而，当在对 HPV 进行调整的研究中估计汇总效应时，未观察到相关性。在控制 HPV 感染的情况下，蔬菜和水果的摄入与宫颈癌的发生率无关。由于分析中仅包括一项队列研究，因此证据水平有限。
