Non-Genetic Factors and Risk of Cervical Cancer: An Umbrella Review of Systematic Reviews and Meta-Analyses of Observational Studies

Int J Public Health. 2023 Mar 31:68:1605198. doi: 10.3389/ijph.2023.1605198. eCollection 2023.

Abstract

Objectives: The association between non-genetic risk factors and cervical cancer (CC) remains controversial and unclear. This umbrella review was conducted to evaluate and synthesize previously published systematic reviews and meta-analyses related to non-genetic factors and CC risk. Methods: We searched PubMed, Web of Science, and EMBASE to identify studies investigating the association between extragenetic factors and CC risk. For each article, we calculated the summary effect size and the 95% confidence interval. Specific criteria were used to classify the association into four levels: strong, highly suggestive, suggestive, or weak. Results: A total of 18 meta-analyses of different risk factors for CC were examined; these studies covered risk factors related to diet, lifestyle, reproduction, disease, viral infection, microorganisms, and parasites. Oral contraceptive use and Chlamydia trachomatis infection were shown to increase CC risk, and this was supported by strong evidence. Additionally, there were four risk factors supported by highly suggestive evidence and six risk factors supported by suggestive evidence. Conclusion: In conclusion, there is a strong association between oral contraceptive use, Chlamydia trachomatis infection, and increased CC risk.

Keywords: cervical cancer; evidence; meta-analyses; risk factors; umbrella review.

Publication types

  • Review

MeSH terms

  • Contraceptives, Oral
  • Female
  • Humans
  • Meta-Analysis as Topic
  • Observational Studies as Topic
  • Risk Factors
  • Systematic Reviews as Topic
  • Uterine Cervical Neoplasms* / epidemiology
  • Uterine Cervical Neoplasms* / genetics

Substances

  • Contraceptives, Oral

Grants and funding

This work was supported by the Natural Science Foundation of China (No. 82073647 and No. 81602918 to Q-JW), LiaoNing Revitalization Talents Program (No. XLYC1907102 to Q-JW), Outstanding Scientific Fund of Shengjing Hospital (Q-JW), and 345 Talent Project of Shengjing Hospital of China Medical University (No. MJ0268 to Q-JW).