Bhuvanendran Pillai Anaanthan, Mun Wong Chin, Dalila Inche Zainal Abidin Noor, Fazlinda Syed Nor Sharifah, Fathulzhafran Mohamed Hanan Mohd, Rasidah Abd Ghani Siti, Afzan Aminuddin Nurul, Safian Nazarudin
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Department of Pharmacy, Hospital Tuanku Ja'afar, Seremban, Negeri Sembilan, Malaysia.
Iran J Public Health. 2022 Mar;51(3):508-517. doi: 10.18502/ijph.v51i3.8926.
We reviewed studies on the prevalence of infection as a risk factor for developing cervical cancer in a meta-analysis studies published in that subject area.
Cochrane Library and PubMed databases were systematically searched for articles (observational and randomized controlled trials) published from 2008-2018. A meta-analysis of studies was performed to analyse the association between chlamydia infection and cervical cancer.
Five articles were included in the final analysis (N=5271). All five articles were case-control studies, of which three studies sampled from population-based registries. All studies involved with sexually active women with minimum 15 years old. Three studies reported the association of infection cervical cancers, two other studies reported co-infection in association with cervical cancer. Result showed has an overall prevalence of 31.9%, pooled OR 1.96, 95% CI 1.05 to 3.67, OR 2.13, 95% CI 1.78 to 2.54 among cervical cancer. There was a mild publication bias detected at 3.0 effect estimation. Heterogeneity detected from clinical and methodological diversities particularly from co-infection subgroup analysis, including sampling bias, geographical strain diversity, and different outcome endpoint measured.
infection was significantly associated with the development of cervical cancer. Co-infection of with cervical cancer is plausibly sound but temporality of with the development of cervical cancer need to be proven in future prospective cohort studies.
我们在该主题领域发表的一项荟萃分析研究中,回顾了关于感染作为宫颈癌发生风险因素的患病率研究。
系统检索Cochrane图书馆和PubMed数据库中2008年至2018年发表的文章(观察性和随机对照试验)。对研究进行荟萃分析,以分析衣原体感染与宫颈癌之间的关联。
最终分析纳入了5篇文章(N = 5271)。所有5篇文章均为病例对照研究,其中3项研究从基于人群的登记处抽样。所有研究均涉及性活跃的15岁及以上女性。3项研究报告了感染与宫颈癌的关联,另外2项研究报告了合并感染与宫颈癌的关联。结果显示,在宫颈癌中,总体患病率为31.9%,合并比值比为1.96,95%置信区间为1.05至3.67,比值比为2.13,95%置信区间为1.78至2.54。在效应估计为3.0时检测到轻度发表偏倚。从临床和方法学差异中检测到异质性,特别是在合并感染亚组分析中,包括抽样偏倚、地理菌株多样性和测量的不同结局终点。
感染与宫颈癌的发生显著相关。感染与宫颈癌的合并感染似乎合理,但感染与宫颈癌发生的时间关系需要在未来的前瞻性队列研究中得到证实。