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

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 r...

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Autores principales: Loghmani, Laleh, Saedi, Nafise, Omani-Samani, Reza, Safiri, Saeid, Sepidarkish, Mahdi, Maroufizadeh, Saman, Esmailzadeh, Arezoo, Shokrpour, Maryam, Khedmati Morasae, Esmaeil, Almasi-Hashiani, Amir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788032/
https://www.ncbi.nlm.nih.gov/pubmed/31604465
http://dx.doi.org/10.1186/s12885-019-6174-3
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author Loghmani, Laleh
Saedi, Nafise
Omani-Samani, Reza
Safiri, Saeid
Sepidarkish, Mahdi
Maroufizadeh, Saman
Esmailzadeh, Arezoo
Shokrpour, Maryam
Khedmati Morasae, Esmaeil
Almasi-Hashiani, Amir
author_facet Loghmani, Laleh
Saedi, Nafise
Omani-Samani, Reza
Safiri, Saeid
Sepidarkish, Mahdi
Maroufizadeh, Saman
Esmailzadeh, Arezoo
Shokrpour, Maryam
Khedmati Morasae, Esmaeil
Almasi-Hashiani, Amir
author_sort Loghmani, Laleh
collection PubMed
description 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 (I(2) = 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 (< 5%), different effect sizes were considered as comparable measures of risk. Therefore we pooled ten studies and SOR of these studies revealed that tubal ligation was significantly associated with a lower risk of endometrial cancer (SOR = 0.696, 95% CI = 0.425–0.966). Besides that, we pooled eight studies in which adjusted effect sizes were reported and a subsequent analysis revealed that the summary estimate of adjusted odds ratio (SAOR) was significant (SAOR = 0.862, 95% CI = 0.698–1.026). CONCLUSIONS: This study revealed a protective effect of tubal ligation on endometrial cancer risk (approximately 42% lower risk of cancer). It is recommended that studies should be designed to reveal mechanisms of this relationship.
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spelling pubmed-67880322019-10-18 Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysis Loghmani, Laleh Saedi, Nafise Omani-Samani, Reza Safiri, Saeid Sepidarkish, Mahdi Maroufizadeh, Saman Esmailzadeh, Arezoo Shokrpour, Maryam Khedmati Morasae, Esmaeil Almasi-Hashiani, Amir BMC Cancer Research Article 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 (I(2) = 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 (< 5%), different effect sizes were considered as comparable measures of risk. Therefore we pooled ten studies and SOR of these studies revealed that tubal ligation was significantly associated with a lower risk of endometrial cancer (SOR = 0.696, 95% CI = 0.425–0.966). Besides that, we pooled eight studies in which adjusted effect sizes were reported and a subsequent analysis revealed that the summary estimate of adjusted odds ratio (SAOR) was significant (SAOR = 0.862, 95% CI = 0.698–1.026). CONCLUSIONS: This study revealed a protective effect of tubal ligation on endometrial cancer risk (approximately 42% lower risk of cancer). It is recommended that studies should be designed to reveal mechanisms of this relationship. BioMed Central 2019-10-11 /pmc/articles/PMC6788032/ /pubmed/31604465 http://dx.doi.org/10.1186/s12885-019-6174-3 Text en © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Loghmani, Laleh
Saedi, Nafise
Omani-Samani, Reza
Safiri, Saeid
Sepidarkish, Mahdi
Maroufizadeh, Saman
Esmailzadeh, Arezoo
Shokrpour, Maryam
Khedmati Morasae, Esmaeil
Almasi-Hashiani, Amir
Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysis
title Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysis
title_full Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysis
title_fullStr Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysis
title_full_unstemmed Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysis
title_short Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysis
title_sort tubal ligation and endometrial cancer risk: a global systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788032/
https://www.ncbi.nlm.nih.gov/pubmed/31604465
http://dx.doi.org/10.1186/s12885-019-6174-3
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