Sturt Amy, Omar Tanvier, Hansingo Isaiah, Kamfwa Paul, Bustinduy Amaya, Kelly Helen
Infectious Diseases Section, Veterans Affairs Health Care System, Palo Alto, CA, USA.
Department of Infectious Diseases and Geographic Medicine, Stanford University, 300 Pasteur Drive, Lane Building 134, Stanford, CA, 94025, USA.
BMC Womens Health. 2025 Jan 3;25(1):2. doi: 10.1186/s12905-024-03514-0.
S. haematobium is a recognized carcinogen and is associated with squamous cell carcinoma of the bladder. Its association with high-risk(HR) human papillomavirus (HPV) persistence, cervical pre-cancer and cervical cancer incidence has not been fully explored.
We searched OvidSP MEDLINE, OvidSP Embase, Global Index Medicus, PubMed and the Wiley Cochrane library without date or language restrictions up to April 20, 2024 for abstracts evaluating the association of female genital schistosomiasis (FGS) with the prevalence, incidence or persistence of cervical HR-HPV, and incidence of histology-verified cervical pre-cancer or cancer. Cervical pre-cancer defined using cervical cytology or visual inspection with acetic acid (VIA) was also considered, but as lower quality evidence. We assessed the risk of bias of included studies using a modified Newcastle Ottawa scale. This study is registered on PROSPERO: CRD42023389301.
We identified 1,170 publications and six studies were eligible for inclusion. Five studies were cross sectional and 1 was prospective. The studies describe 1081 women living in sub-Saharan Africa. One study from Zimbabwe reported an increased risk of HR-HPV prevalence at baseline in women with composite-FGS compared to women without FGS (aOR 1.9, 95% CI 1.1 - 3.6, p = 0.03), however no association was seen after 5 years of follow-up. Another study from KwaZulu-Natal reported an increased odds of any HPV prevalence among women with visual-FGS compared to women without FGS (aOR 1.71 [1.14 - 2.56], p = 0.01). However, a study in Madagascar did not show increased odds of any HPV among women with visual-FGS compared to women without FGS (OR 1.0 [0.82 - 1.2). Of 4 studies evaluating the association of FGS and cervical pre-cancer, one reported an increased risk of VIA abnormalities in women with molecular-FGS compared to those without (aOR 6.08, 95% CI 1.58 - 23.37). Three studies did not report an association between FGS and cervical pre-cancer (cytology defined (n = 2) and histology defined (n = 1)).
There are limited and low quality data on the risk of HR-HPV infection and cervical pre-cancer and cancer among women with FGS. Given limited data, it was not possible to confirm or exclude an association between FGS and HPV, cervical pre-cancer, and cervical cancer and additional research is needed.
埃及血吸虫是一种公认的致癌物，与膀胱癌的鳞状细胞癌有关。其与高危（HR）人乳头瘤病毒（HPV）持续感染、宫颈上皮内瘤变和宫颈癌发病率之间的关联尚未得到充分研究。
我们检索了OvidSP MEDLINE、OvidSP Embase、全球医学索引、PubMed和Wiley Cochrane图书馆，检索时间截至2024年4月20日，无日期或语言限制，以查找评估女性生殖器血吸虫病（FGS）与宫颈HR-HPV的患病率、发病率或持续感染以及经组织学证实的宫颈上皮内瘤变或癌症发病率之间关联的摘要。使用宫颈细胞学或醋酸肉眼观察（VIA）定义的宫颈上皮内瘤变也被纳入考虑，但作为质量较低的证据。我们使用改良的纽卡斯尔渥太华量表评估纳入研究的偏倚风险。本研究已在PROSPERO注册：CRD42023389301。
我们共识别出1170篇文献，其中6项研究符合纳入标准。5项研究为横断面研究，1项为前瞻性研究。这些研究共涉及1081名生活在撒哈拉以南非洲的女性。津巴布韦的一项研究报告称，与无FGS的女性相比，合并FGS的女性在基线时HR-HPV感染率增加（调整后比值比[aOR]为1.9，95%置信区间[CI]为1.1 - 3.6，p = 0.03），但随访5年后未发现关联。夸祖鲁 - 纳塔尔的另一项研究报告称，与无FGS的女性相比，有肉眼可见FGS的女性中任何HPV感染率的比值比增加（aOR 1.71[1.14 - 2.56]，p = 0.01）。然而，马达加斯加的一项研究未显示有肉眼可见FGS的女性中任何HPV感染率的比值比增加（比值比[OR]为1.0[0.82 - 1.2]）。在4项评估FGS与宫颈上皮内瘤变关联的研究中，1项研究报告称，与无分子FGS的女性相比，有分子FGS的女性VIA异常风险增加（aOR 6.08，95% CI 1.58 -
