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Number of parity and the risk of gallbladder cancer: a systematic review and dose-response meta-analysis of observational studies.
Arch Gynecol Obstet 2016; 293(5):1087-96AG

Abstract

BACKGROUND

Current epidemiological evidence suggests an association between parity and risk of gallbladder cancer (GBC), but studies have yielded inconsistent conclusions.

OBJECTIVE

The purpose of this meta-analysis is to systematically analyze the effect of the number of parity on GBC risk.

METHODS

We searched Web of Science, EMBASE, PubMed, China Biological Medicine Database from inception to the end of April 2015. Studies investigating parity and risk of GBC were included. A systematic review and a dose-response meta-analysis were performed to investigate the association between parity and GBC risk using odds ratios (OR) and 95 % confidence intervals (CI).

RESULTS

Thirteen case-control studies were eligible for inclusion in this meta-analysis, including a total of 2,164 cases and 11,340 controls. A significant association was identified for the ever parity vs. nulliparous at 1.39 (95 % CI 1.15-1.68; Power = 0.73; I (2) =0.0 %; P = 0.90). Similarly, the summary estimate for high vs. low parity number was 1.86 (95 % CI 1.51-2.30; Power = 0.26; I (2) = 66.0 % P < 0.01). For the dose-response relationship, a non-linear association between the parity number and GBC risk was not observed (P non-linearity = 0.578), but a clear linear relationship was detected. The combined odds ratio of GBC for an increase in parity of one live birth was 1.12 (95 % CI 1.09-1.21; Power = 0.99; I (2) = 39.9 %; P = 0.139). Subgroup and sensitivity analyses showed similar associations. No publication bias was found in all results. Significant heterogeneity between subgroups was detected by meta-regression analyses.

CONCLUSIONS

In females, higher parity may be associated with an increased risk of gallbladder cancer. In the future, high-quality cohort studies with larger sample sizes and randomized controlled trials are needed to fully scrutinize this association.

Authors+Show Affiliations

General Surgery, The Third Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, 98 Fenghuangbei Road, Zunyi, 563000, China.Department of Urology, Zhongnan Hospital of Wuhan University, Center of Evidence Based and Transformation Medicine of Wuhan University, Wuhan, 430071, China.Department of Science and Education, First People's Hospital of Changde City, Changde, 415003, China.Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, 563000, China.Department of Immunity, Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, 563000, China.Institute of Public Health, Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, 563099, China.College of Medicine and Nursing of HuBei Medical University, HuBei Medical University, Shiyan, 442200, China.General Surgery, The Third Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, 98 Fenghuangbei Road, Zunyi, 563000, China. fengchunlin_zy@163.com.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

26408005

Citation

Guo, Peng, et al. "Number of Parity and the Risk of Gallbladder Cancer: a Systematic Review and Dose-response Meta-analysis of Observational Studies." Archives of Gynecology and Obstetrics, vol. 293, no. 5, 2016, pp. 1087-96.
Guo P, Xu C, Zhou Q, et al. Number of parity and the risk of gallbladder cancer: a systematic review and dose-response meta-analysis of observational studies. Arch Gynecol Obstet. 2016;293(5):1087-96.
Guo, P., Xu, C., Zhou, Q., Zhou, J., Zhao, J., Si, Z., ... Feng, C. (2016). Number of parity and the risk of gallbladder cancer: a systematic review and dose-response meta-analysis of observational studies. Archives of Gynecology and Obstetrics, 293(5), pp. 1087-96. doi:10.1007/s00404-015-3896-6.
Guo P, et al. Number of Parity and the Risk of Gallbladder Cancer: a Systematic Review and Dose-response Meta-analysis of Observational Studies. Arch Gynecol Obstet. 2016;293(5):1087-96. PubMed PMID: 26408005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Number of parity and the risk of gallbladder cancer: a systematic review and dose-response meta-analysis of observational studies. AU - Guo,Peng, AU - Xu,Chang, AU - Zhou,Quan, AU - Zhou,JianGuo, AU - Zhao,JuanJuan, AU - Si,ZhuangLi, AU - Shen,Cheng, AU - Feng,ChunLin, Y1 - 2015/09/25/ PY - 2015/07/06/received PY - 2015/09/14/accepted PY - 2015/9/27/entrez PY - 2015/9/27/pubmed PY - 2016/9/30/medline KW - Dose–response meta-analysis KW - Gallbladder cancer KW - Parity KW - Risk factor KW - Systematic review SP - 1087 EP - 96 JF - Archives of gynecology and obstetrics JO - Arch. Gynecol. Obstet. VL - 293 IS - 5 N2 - BACKGROUND: Current epidemiological evidence suggests an association between parity and risk of gallbladder cancer (GBC), but studies have yielded inconsistent conclusions. OBJECTIVE: The purpose of this meta-analysis is to systematically analyze the effect of the number of parity on GBC risk. METHODS: We searched Web of Science, EMBASE, PubMed, China Biological Medicine Database from inception to the end of April 2015. Studies investigating parity and risk of GBC were included. A systematic review and a dose-response meta-analysis were performed to investigate the association between parity and GBC risk using odds ratios (OR) and 95 % confidence intervals (CI). RESULTS: Thirteen case-control studies were eligible for inclusion in this meta-analysis, including a total of 2,164 cases and 11,340 controls. A significant association was identified for the ever parity vs. nulliparous at 1.39 (95 % CI 1.15-1.68; Power = 0.73; I (2) =0.0 %; P = 0.90). Similarly, the summary estimate for high vs. low parity number was 1.86 (95 % CI 1.51-2.30; Power = 0.26; I (2) = 66.0 % P < 0.01). For the dose-response relationship, a non-linear association between the parity number and GBC risk was not observed (P non-linearity = 0.578), but a clear linear relationship was detected. The combined odds ratio of GBC for an increase in parity of one live birth was 1.12 (95 % CI 1.09-1.21; Power = 0.99; I (2) = 39.9 %; P = 0.139). Subgroup and sensitivity analyses showed similar associations. No publication bias was found in all results. Significant heterogeneity between subgroups was detected by meta-regression analyses. CONCLUSIONS: In females, higher parity may be associated with an increased risk of gallbladder cancer. In the future, high-quality cohort studies with larger sample sizes and randomized controlled trials are needed to fully scrutinize this association. SN - 1432-0711 UR - https://www.unboundmedicine.com/medline/citation/26408005/Number_of_parity_and_the_risk_of_gallbladder_cancer:_a_systematic_review_and_dose_response_meta_analysis_of_observational_studies_ L2 - https://dx.doi.org/10.1007/s00404-015-3896-6 DB - PRIME DP - Unbound Medicine ER -