Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China.
Int J Cancer. 2020 Oct 15;147(8):2121-2130. doi: 10.1002/ijc.33012. Epub 2020 Apr 25.
Epidemiological studies have investigated the relationship between infertility and the risk of ovarian cancer (OC); however, the results have been inconsistent. We therefore conducted the first meta-analysis to update and quantify the aforementioned association based on prospective cohort studies. Studies were identified by searching PubMed, EMBASE and Web of Science databases up to January 8, 2020. We extracted data from the studies and performed quality assessments. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Publication bias, and subgroup, meta-regression and sensitivity analyses were also conducted. Nine prospective cohort studies with a total of 10 383 OC cases and 6 278 830 participants were included in the present study. The summary RR of the association between infertility and the risk of OC was 1.51 (95% CI: 1.35-1.69), with low heterogeneity. Positive associations were observed in most subgroup analyses stratified by predefined factors, including region, duration of follow-up, study quality, causes of infertility, invasiveness of OC, infertility treatment status and adjustment of potential confounding parameters. No significant publication bias was detected. Our findings suggest that infertility in women were associated with an increased risk of OC.
流行病学研究调查了不孕与卵巢癌（OC）风险之间的关系；然而，结果并不一致。因此，我们进行了首次荟萃分析，以基于前瞻性队列研究更新和量化上述关联。研究通过检索 PubMed、EMBASE 和 Web of Science 数据库至 2020 年 1 月 8 日进行。我们从研究中提取数据并进行质量评估。使用随机效应模型计算汇总相对风险（RR）及其 95%置信区间（CI）。还进行了发表偏倚、亚组、meta 回归和敏感性分析。本研究纳入了 9 项前瞻性队列研究，共包括 10383 例 OC 病例和 6278830 名参与者。不孕与 OC 风险之间关联的汇总 RR 为 1.51（95%CI：1.35-1.69），异质性较低。在根据预先确定的因素分层的大多数亚组分析中观察到阳性关联，包括地区、随访时间、研究质量、不孕原因、OC 的侵袭性、不孕治疗状况以及调整潜在混杂参数。未发现显著的发表偏倚。我们的研究结果表明，女性不孕与 OC 风险增加相关。
