Article Text

Protocol
Metabolic disorders and the risk of head and neck cancer: a protocol for a systematic review and meta-analysis
  1. Alexander Gormley1,2,
  2. Charlotte Richards3,
  3. Francesca Spiga4,5,
  4. Emily Gray2,
  5. Joanna Hooper6,
  6. Barry Main1,4,
  7. Emma E Vincent5,7,
  8. Rebecca Richmond4,5,
  9. Julian Higgins4,5,
  10. Mark Gormley1,5
  1. 1 Bristol Dental School, Faculty of Health Sciences, University of Bristol, Bristol, UK
  2. 2 Bristol Dental Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
  3. 3 School of Dentistry, Cardiff University, Cardiff, UK
  4. 4 Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
  5. 5 MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
  6. 6 Library and Information Services, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
  7. 7 School of Cellular and Molecular Medicine, Faculty of Life Sciences, University of Bristol, Bristol, UK
  1. Correspondence to Mr Mark Gormley; mark.gormley{at}bristol.ac.uk

Abstract

Introduction Head and neck cancer squamous cell carcinoma (HNSCC) is the sixth most common cancer internationally. Established risk factors include smoking, alcohol and presence of human papillomavirus (HPV). The incidence rate of new disease continues to rise, despite falls in alcohol consumption and a reduction in smoking, the rising rates are unlikely to be solely attributed to HPV status alone. Obesity and its associated conditions such as type 2 diabetes (T2D) are implicated in the risk and progression of a variety of cancers, but there is paucity of evidence regarding its role in HNSCC.

Methods and analysis A systematic review of cohort studies, reporting a risk of incident HNSCC, will be included. A systematic search strategy has been developed, multiple databases will be searched from January 1966 to November 2021, including Cochrane Library, OVID SP versions of Medline and EMBASE. The primary outcome will be incident HNSCC based on exposures of T2D, obesity, dyslipidaemia and hypertension as defined by the WHO. A combined risk effect across studies will be calculated using meta-analysis, although depending on the heterogeneity in study design, exposure and outcome reporting this may not be possible.

Ethics and dissemination No ethical approval is required for this systematic review. The review will be published in a relevant peer-review journal and findings will be presented at scientific meetings in both poster and oral presentation form.

PROSPERO registration number details This study has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) with study registration number CRD42021250520. This protocol has been developed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidance statement.

  • ONCOLOGY
  • ORAL & MAXILLOFACIAL SURGERY
  • Head & neck tumours
  • Hypertension
  • Lipid disorders
  • DIABETES & ENDOCRINOLOGY
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Footnotes

  • AG and CR are joint first authors.

  • Twitter @Gormley, @bgmain1

  • Contributors AG and CR jointly contributed to the development of the protocol and the drafting, writing and editing of this manuscript. FS contributed to the development of this study and editing of the manuscript. JH contributed to the development of the search strategy. BM, EG, EEV, RR and JH contributed to the development of this study. MG was responsible for conceptualising this study, drafting and editing this manuscript. All authors contributed to the development of the search strategy. All authors have approved and contributed to the final written manuscript.

  • Funding AG is a National Institute for Health Research (NIHR) academic clinical fellow (no grant number). FS was supported by a Cancer Research UK (C18281/A29019) programme grant (the Integrative Cancer Epidemiology Programme). EEV is supported by Diabetes UK (17/0005587). EEV is also supported by the World Cancer Research Fund (WCRF UK), as part of the World Cancer Research Fund International grant programme (IIG_2019_2009). RR. is a de Pass VC research fellow at the University of Bristol (no grant number). JH supported by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol (no grant number), the NIHR Applied Research Collaboration West at University Hospitals Bristol and Weston NHS Foundation Trust (no grant number) and is an NIHR Senior Investigator (no grant number). MG is currently supported by a Wellcome Trust GW4-Clinical Academic Training PhD Fellowship. This research was funded in part, by the Wellcome Trust (grant number 220530/Z/20/Z). For the purpose of open access, the author has applied a CC BY public copyright licence to any author accepted manuscript version arising from this submission. The views expressed in this publication are those of the author(s) and not necessarily those of Wellcome, NIHR, the NHS or Department of Health.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.