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Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysis.

ABSTRACT: BACKGROUND:Studies on relationship between tubal ligation and endometrial cancer have led to contradictory findings. In several studies, however, a reduced endometrial cancer risk was suggested following tubal ligation. Therefore, a systematic review and meta-analysis was conducted to examine the relationship between tubal ligation and endometrial cancer risk. METHODS:In this systematic review and meta-analysis, PubMed/Medline, Web of Science, Scopus, Embase, and Google Scholar were searched for relevant studies published up to May 30th, 2018. We compared endometrial cancer risk in women with and without tubal ligation in retrieved studies. RESULTS:Two hundred nine studies were initially retrieved from the data bases. After exclusion of duplicates and studies which did not meet inclusion criteria, ten cohort and case-control studies, including 6,773,066 cases, were entered into the quantitative meta-analysis. There was 0.90% agreement between two researchers who searched and retrieved the studies. The summary OR (SOR) was reported using a random effect model. Begg's test suggested that there was no publication bias, but a considerable heterogeneity was observed (I2 =?95.4%, P?=?0.001). We pooled the raw number of tables cells (i.e. a, b, c, and d) of eight studies. The SOR suggested that tubal ligation was significantly associated with a lower risk of endometrial cancer (SOR?=?0.577, 95% CI?=?0.420-0.792). Also, given the rare nature of endometrial cancer (

SUBMITTER: Loghmani L

PROVIDER: S-EPMC6788032 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysis.

Loghmani Laleh L Saedi Nafise N Omani-Samani Reza R Safiri Saeid S Sepidarkish Mahdi M Maroufizadeh Saman S Esmailzadeh Arezoo A Shokrpour Maryam M Khedmati Morasae Esmaeil E Almasi-Hashiani Amir A

BMC cancer 20191011 1

<h4>Background</h4>Studies on relationship between tubal ligation and endometrial cancer have led to contradictory findings. In several studies, however, a reduced endometrial cancer risk was suggested following tubal ligation. Therefore, a systematic review and meta-analysis was conducted to examine the relationship between tubal ligation and endometrial cancer risk.<h4>Methods</h4>In this systematic review and meta-analysis, PubMed/Medline, Web of Science, Scopus, Embase, and Google Scholar we ...[more]

PMID: 31604465

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Project description:ImportanceAs the worldwide burden of endometrial cancer continues to rise, interest is growing in the evaluation of early detection and prevention strategies among women at increased risk. Focusing efforts on women with postmenopausal bleeding (PMB), a common symptom of endometrial cancer, may be a useful strategy; however, PMB is not specific for endometrial cancer and is often caused by benign conditions.ObjectiveTo provide a reference of the prevalence of PMB in endometrial cancers and the risk of endometrial cancer in women with PMB.Data sourcesFor this systematic review and meta-analysis, PubMed and Embase were searched for English-language studies published January 1, 1977, through January 31, 2017.Study selectionObservational studies reporting the prevalence of PMB in women with endometrial cancer and the risk of endometrial cancer in women with PMB in unselected populations were selected.Data extraction and synthesisTwo independent reviewers evaluated study quality and risk of bias using items from the Newcastle-Ottawa Quality Assessment Scale and the Quality Assessment of Diagnostic Accuracy Studies tool. Studies that included highly selected populations, lacked detailed inclusion criteria, and/or included 25 or fewer women were excluded.Main outcomes and measuresThe pooled prevalence of PMB in women with endometrial cancer and the risk of endometrial cancer in women with PMB.ResultsA total of 129 unique studies, including 34 432 unique patients with PMB and 6358 with endometrial cancer (40 790 women), were analyzed. The pooled prevalence of PMB among women with endometrial cancer was 91% (95% CI, 87%-93%), irrespective of tumor stage. The pooled risk of endometrial cancer among women with PMB was 9% (95% CI, 8%-11%), with estimates varying by use of hormone therapy (range, 7% [95% CI, 6%-9%] to 12% [95% CI, 9%-15%]; P < .001 for heterogeneity) and geographic region (range, 5% [95% CI, 3%-11%] in North America to 13% [95% CI, 9%-19%] in Western Europe; P = .09 for heterogeneity).Conclusions and relevanceEarly detection strategies focused on women with PMB have the potential to capture as many as 90% of endometrial cancers; however, most women with PMB will not be diagnosed with endometrial cancer. These results can aid in the assessment of the potential clinical value of new early detection markers and clinical management strategies for endometrial cancer and will help to inform clinical and epidemiologic risk prediction models to support decision making.

Dataset Information

Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysis.

Publications

Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysis.

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