You are here

Article Text

Article menu
XML
Obstetrics and gynaecology
Research
Tobacco smoking and risk of endometriosis: a systematic review and meta-analysis
  1. Francesca Bravi1,
  2. Fabio Parazzini1,2,
  3. Sonia Cipriani1,2,
  4. Francesca Chiaffarino2,
  5. Elena Ricci2,
  6. Vito Chiantera3,
  7. Paola Viganò4,
  8. Carlo La Vecchia1
  1. 1Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
  2. 2Department of Obstetrics, Gynecology and Neonatology, IRCSS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
  3. 3Department of Gynecology, Charitè Universitätsmedizin, Berlin, Germany
  4. 4Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milan, Lombardia, Italy
  1. Correspondence to Dr Fabio Parazzini; Fabio.Parazzini{at}unimi.it

Abstract

Objective Since conflicting results have been published on the role of tobacco smoking on the risk of endometriosis, we provide an up-to-date summary quantification of this potential association.

Design We performed a PubMed/MEDLINE search of the relevant publications up to September 2014, considering studies on humans published in English. We searched the reference list of the identified papers to find other relevant publications. Case–control as well as cohort studies have been included reporting risk estimates on the association between tobacco smoking and endometriosis. 38 of the 1758 screened papers met the inclusion criteria. The selected studies included a total of 13 129 women diagnosed with endometriosis.

Setting Academic hospitals.

Main outcome measure Risk of endometriosis in tobacco smokers.

Results We obtained the summary estimates of the relative risk (RR) using the random effect model, and assessed the heterogeneity among studies using the χ2 test and quantified it using the I2 statistic. As compared to never-smokers, the summary RR were 0.96 (95% CI 0.86 to 1.08) for ever smokers, 0.95 (95% CI 0.81 to 1.11) for former smokers, 0.92 (95% CI 0.82 to 1.04) for current smokers, 0.87 (95% CI 0.70 to 1.07) for moderate smokers and 0.93 (95% CI 0.69 to 1.26) for heavy smokers.

Conclusions The present meta-analysis provided no evidence for an association between tobacco smoking and the risk of endometriosis. The results were consistent considering ever, former, current, moderate and heavy smokers, and across type of endometriosis and study design.

  • GYNAECOLOGY
  • EPIDEMIOLOGY

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) 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/4.0/

http://dx.doi.org/10.1136/bmjopen-2014-006325

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Supplementary materials

    • Supplementary Data

      This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

      Files in this Data Supplement: