Article Text

Evidence for the aetiology of human papillomavirus in oesophageal squamous cell carcinoma in the Chinese population: a meta-analysis
  1. Surabhi S Liyanage1,
  2. Bayzidur Rahman1,
  3. Zhanhai Gao1,
  4. Yang Zheng2,
  5. Iman Ridda3,
  6. Aye Moa1,
  7. Anthony T Newall1,
  8. Holly Seale1,
  9. Qian Li4,
  10. Jun-Feng Liu4,
  11. C Raina MacIntyre1,3
  1. 1School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia
  2. 2Centre for Disease Control and Prevention, Beijing, China
  3. 3National Centre for Immunization Research and Surveillance (NCIRS), Sydney, New South Wales, Australia
  4. 4Department of Surgery, Fourth Hospital, Shijiazhuang, Hebei, China
  1. Correspondence to Dr Surabhi S Liyanage; surabhi_liyanage{at}hotmail.com

Abstract

Objectives We aimed to conduct a meta-analysis of human papillomavirus (HPV) as a risk factor for oesophageal squamous cell carcinoma (OSCC) in China, using all eligible studies published in the English and Chinese language literature.

Design The random effect model was used to analyse the pooled OR. The I2 and Q tests were included in the subgroup analyses.

Setting Literature searches of databases including MEDLINE, PUBMED, EMBASE and Chinese National Knowledge Infrastructure (CNKI) and other available resources were performed to retrieve studies investigating OSCC tissue from Chinese participants for the presence of HPV DNA.

Primary outcome measure A collective analysis of OSCC cases and control specimens was carried out from 15 case–control studies (6 in the English language and 9 in the Chinese language) for HPV prevalence.

Results Of a total of 1177 OSCC and 1648 oesophageal control samples, 55% (642/1177) of cancer specimens and 27% (445/1648) of control samples were positive for HPV DNA. A positive strong association between HPV DNA and OSCC was observed among the included studies, with a pooled OR of 3.69 (95% CI 2.74 to 4.96). Heterogeneity and publication bias were not observed in the analysis. Subgroup analyses of the included studies also supported the measure of association of causal links between HPV and OSCC.

Conclusions This meta-analysis provides the strongest evidence until now of an association between HPV and OSCC in the Chinese population. China has a high burden of OSCC, making this an important research finding. A strength and new contribution of this study is combining data from the English and Chinese language literature to analyse all studies conducted in China. These findings may inform the population level use of prophylactic HPV vaccination to reduce the burden of OSCC in China.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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