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 exami...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-10-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-019-6174-3 |
| _version_ | 1818049122585804800 |
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| author | Laleh Loghmani Nafise Saedi Reza Omani-Samani Saeid Safiri Mahdi Sepidarkish Saman Maroufizadeh Arezoo Esmailzadeh Maryam Shokrpour Esmaeil Khedmati Morasae Amir Almasi-Hashiani |
| author_facet | Laleh Loghmani Nafise Saedi Reza Omani-Samani Saeid Safiri Mahdi Sepidarkish Saman Maroufizadeh Arezoo Esmailzadeh Maryam Shokrpour Esmaeil Khedmati Morasae Amir Almasi-Hashiani |
| author_sort | Laleh Loghmani |
| collection | DOAJ |
| description | 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 (< 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. |
| first_indexed | 2024-12-10T10:32:34Z |
| format | Article |
| id | doaj.art-878d07c2e41541d690ba702246c46c13 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-10T10:32:34Z |
| publishDate | 2019-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-878d07c2e41541d690ba702246c46c132022-12-22T01:52:31ZengBMCBMC Cancer1471-24072019-10-0119111110.1186/s12885-019-6174-3Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysisLaleh Loghmani0Nafise Saedi1Reza Omani-Samani2Saeid Safiri3Mahdi Sepidarkish4Saman Maroufizadeh5Arezoo Esmailzadeh6Maryam Shokrpour7Esmaeil Khedmati Morasae8Amir Almasi-Hashiani9Department of Nursing, Faculty of Nursing and Midwifery, Bam University of Medical SciencesDepartment of Gynecologic Oncology, Tehran University of Medical SciencesDepartment of Medical Ethics and Law, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECRAging Research Institute, Tabriz University of Medical SciencesDepartment of Biostatistics and Epidemiology, Babol University of Medical SciencesSchool of Nursing and Midwifery, Guilan University of Medical SciencesDepartment of Obstetrics and Gynecology, Baqiyatallah University of Medical SciencesDepartment of Obstetrics and Gynecology, Arak University of Medical SciencesInstitute of Psychology, Health, and Society, Department of Health Services Research, University of LiverpoolDepartment of Epidemiology, School of Health, Arak University of Medical SciencesAbstract 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 (< 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.http://link.springer.com/article/10.1186/s12885-019-6174-3Endometrial neoplasmsTubal sterilizationTubal ligationMeta-analysis |
| spellingShingle | Laleh Loghmani Nafise Saedi Reza Omani-Samani Saeid Safiri Mahdi Sepidarkish Saman Maroufizadeh Arezoo Esmailzadeh Maryam Shokrpour Esmaeil Khedmati Morasae Amir Almasi-Hashiani Tubal ligation and endometrial Cancer risk: a global systematic review and meta-analysis BMC Cancer Endometrial neoplasms Tubal sterilization Tubal ligation 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 | Endometrial neoplasms Tubal sterilization Tubal ligation Meta-analysis |
| url | http://link.springer.com/article/10.1186/s12885-019-6174-3 |
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