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The association between Parkinson's disease and melanoma: a systematic review and meta-analysis.

Huang P, Yang XD, Chen SD, Xiao Q - Transl Neurodegener (2015)

Bottom Line: Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated by random-effects models.In addition, we found the risk of non-melanoma skin cancers in PD was slightly higher (OR 1.20, 95 % CI 1.11-1.29) than general population.Most of the evidences were of high quality, and the conclusion was robust.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology & Institute of Neurology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China.

ABSTRACT

Objective: To assess the association between Parkinson's disease (PD) and melanoma via systematic review and meta-analysis.

Methods: Comprehensive search in PubMed, Web of Science, Embase and four China databases (SinoMed, WanFang data, CNKI and VIP database) of epidemiologic evidences on PD and melanoma published before April 30, 2015. Studies which reported risk estimates of melanoma among PD patients or risk estimates of PD in patients with melanoma were included. Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated by random-effects models. Heterogeneity across studies was assessed using Cochran Q and I(2) statistics. Subgroup analyses and sensitivity analyses were conducted to evaluate sources of heterogeneity. Subgroup analyses were done according to temporal relationship, geographic region and gender respectively. We assessed publication bias using the Begg and Egger test. In addition, study appraisal was done using a scale for observational studies to ensure the quality of evidence.

Results: We identified 24 eligible studies on PD and melanoma with a total number of 292,275 PD patients: the pooled OR was 1.83 (95 % CI 1.46-2.30) overall, subgroup analyses by temporal relationship showed that risk of melanoma after PD diagnosis was significantly higher (OR 2.43, 95 % CI 1.77-3.32), but not before the diagnosis of PD (OR 1.09, 95 % CI 0.78-1.54). Subgroup analysis by geographic region showed that increased risk of melanoma in PD was found both in Europe (OR 1.44, 95 % CI 1.22-1.70) and in North America (OR 2.64, 95 % CI 1.63-4.28). Gender-specific subgroup analyses did not show difference between men (OR 1.64, 95 % CI 1.27-2.13) and women (OR 1.38, 95 % CI 1.04-1.82) in the risk of melanoma. In addition, we found the risk of non-melanoma skin cancers in PD was slightly higher (OR 1.20, 95 % CI 1.11-1.29) than general population. It was impossible to evaluate the association between PD and melanoma according to use of levodopa or gene polymorphism via meta-analysis since few observational or cohort studies have focused on it.

Conclusions: An association between PD and melanoma was confirmed. Most of the evidences were of high quality, and the conclusion was robust. Further research is needed to explore the mechanisms underlying this relationship.

No MeSH data available.


Related in: MedlinePlus

Association between melanoma and PD according to temporal relationship. Subtotal = pooled odds ratios (ORs) within each subcategory. Overall = pooled OR for all studies. Squares indicate study specific ORs; error bars indicate 95 % confidence intervals (CIs); diamonds indicate ORs and 95 % CIs from pooled analyses
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Fig2: Association between melanoma and PD according to temporal relationship. Subtotal = pooled odds ratios (ORs) within each subcategory. Overall = pooled OR for all studies. Squares indicate study specific ORs; error bars indicate 95 % confidence intervals (CIs); diamonds indicate ORs and 95 % CIs from pooled analyses

Mentions: A total of 22 studies were included in the analysis, we divided all the 22 studies into three subgroups according to temporal relationship (study design), including “PD diagnosis preceding melanoma (cohort studies)” with 14 studies [1–6, 10, 19–22, 24–26], “melanoma preceding PD diagnosis (case–control studies)” with nine studies [3, 23, 24, 27–32] and “co-occurrence of PD and melanoma (cross-sectional studies)” with only one study [34]. Two studies provided data separately for melanoma before and after PD diagnosis [3, 24]. As shown in Fig. 2, the overall pooled OR was 1.83 (95 % CI 1.46–2.30), however, there was a significant heterogeneity across studies (I2 = 82.4 %, PQ < 0.001). Subgroup analysis showed that the pooled OR for “melanoma preceding PD diagnosis” group was 1.09 (95 % CI 0.78–1.54), with evidence of moderate heterogeneity (I2 = 58.1 %, PQ = 0.014). People with PD had increased risks (OR 2.43, 95 % CI 1.77–3.22) of melanoma compared with those without PD as shown in the “PD diagnosis preceding melanoma” group, with a significant heterogeneity across studies (I2 = 87.8 %, PQ < 0.001). Only one study reported the co-occurrence of PD and melanoma and the OR was 1.83 (95 % CI 0.98–3.40). We examined the source of heterogeneity by excluding the study of poor quality [23]. After excluding this study from the analysis, the pooled OR appeared significantly stronger (OR 1.93, 95 % CI 1.54–2.42), but the heterogeneity was still high (I2 = 82.0 %, PQ < 0.001). When we further exclude the study that reported the highest OR (OR 20.90) [25] and the study that reported the lowest OR (OR 0.48) [31], the pooled OR was 1.80 (95 % CI 1.52–2.14), and the heterogeneity was reduced by nearly 22 % (I2 = 64.5 %, PQ < 0.001). In detail, the heterogeneity in “melanoma preceding PD diagnosis” group was completely eliminated (I2 < 0.1 %, PQ = 0.999), while the heterogeneity in “PD diagnosis preceding melanoma” group was significant (I2 = 78.4 %, PQ < 0.001). To further examine the source of heterogeneity across studies in “PD diagnosis preceding melanoma” group, we did subgroup analysis by geographic region (see the following).Fig. 2


The association between Parkinson's disease and melanoma: a systematic review and meta-analysis.

Huang P, Yang XD, Chen SD, Xiao Q - Transl Neurodegener (2015)

Association between melanoma and PD according to temporal relationship. Subtotal = pooled odds ratios (ORs) within each subcategory. Overall = pooled OR for all studies. Squares indicate study specific ORs; error bars indicate 95 % confidence intervals (CIs); diamonds indicate ORs and 95 % CIs from pooled analyses
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4631109&req=5

Fig2: Association between melanoma and PD according to temporal relationship. Subtotal = pooled odds ratios (ORs) within each subcategory. Overall = pooled OR for all studies. Squares indicate study specific ORs; error bars indicate 95 % confidence intervals (CIs); diamonds indicate ORs and 95 % CIs from pooled analyses
Mentions: A total of 22 studies were included in the analysis, we divided all the 22 studies into three subgroups according to temporal relationship (study design), including “PD diagnosis preceding melanoma (cohort studies)” with 14 studies [1–6, 10, 19–22, 24–26], “melanoma preceding PD diagnosis (case–control studies)” with nine studies [3, 23, 24, 27–32] and “co-occurrence of PD and melanoma (cross-sectional studies)” with only one study [34]. Two studies provided data separately for melanoma before and after PD diagnosis [3, 24]. As shown in Fig. 2, the overall pooled OR was 1.83 (95 % CI 1.46–2.30), however, there was a significant heterogeneity across studies (I2 = 82.4 %, PQ < 0.001). Subgroup analysis showed that the pooled OR for “melanoma preceding PD diagnosis” group was 1.09 (95 % CI 0.78–1.54), with evidence of moderate heterogeneity (I2 = 58.1 %, PQ = 0.014). People with PD had increased risks (OR 2.43, 95 % CI 1.77–3.22) of melanoma compared with those without PD as shown in the “PD diagnosis preceding melanoma” group, with a significant heterogeneity across studies (I2 = 87.8 %, PQ < 0.001). Only one study reported the co-occurrence of PD and melanoma and the OR was 1.83 (95 % CI 0.98–3.40). We examined the source of heterogeneity by excluding the study of poor quality [23]. After excluding this study from the analysis, the pooled OR appeared significantly stronger (OR 1.93, 95 % CI 1.54–2.42), but the heterogeneity was still high (I2 = 82.0 %, PQ < 0.001). When we further exclude the study that reported the highest OR (OR 20.90) [25] and the study that reported the lowest OR (OR 0.48) [31], the pooled OR was 1.80 (95 % CI 1.52–2.14), and the heterogeneity was reduced by nearly 22 % (I2 = 64.5 %, PQ < 0.001). In detail, the heterogeneity in “melanoma preceding PD diagnosis” group was completely eliminated (I2 < 0.1 %, PQ = 0.999), while the heterogeneity in “PD diagnosis preceding melanoma” group was significant (I2 = 78.4 %, PQ < 0.001). To further examine the source of heterogeneity across studies in “PD diagnosis preceding melanoma” group, we did subgroup analysis by geographic region (see the following).Fig. 2

Bottom Line: Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated by random-effects models.In addition, we found the risk of non-melanoma skin cancers in PD was slightly higher (OR 1.20, 95 % CI 1.11-1.29) than general population.Most of the evidences were of high quality, and the conclusion was robust.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology & Institute of Neurology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China.

ABSTRACT

Objective: To assess the association between Parkinson's disease (PD) and melanoma via systematic review and meta-analysis.

Methods: Comprehensive search in PubMed, Web of Science, Embase and four China databases (SinoMed, WanFang data, CNKI and VIP database) of epidemiologic evidences on PD and melanoma published before April 30, 2015. Studies which reported risk estimates of melanoma among PD patients or risk estimates of PD in patients with melanoma were included. Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated by random-effects models. Heterogeneity across studies was assessed using Cochran Q and I(2) statistics. Subgroup analyses and sensitivity analyses were conducted to evaluate sources of heterogeneity. Subgroup analyses were done according to temporal relationship, geographic region and gender respectively. We assessed publication bias using the Begg and Egger test. In addition, study appraisal was done using a scale for observational studies to ensure the quality of evidence.

Results: We identified 24 eligible studies on PD and melanoma with a total number of 292,275 PD patients: the pooled OR was 1.83 (95 % CI 1.46-2.30) overall, subgroup analyses by temporal relationship showed that risk of melanoma after PD diagnosis was significantly higher (OR 2.43, 95 % CI 1.77-3.32), but not before the diagnosis of PD (OR 1.09, 95 % CI 0.78-1.54). Subgroup analysis by geographic region showed that increased risk of melanoma in PD was found both in Europe (OR 1.44, 95 % CI 1.22-1.70) and in North America (OR 2.64, 95 % CI 1.63-4.28). Gender-specific subgroup analyses did not show difference between men (OR 1.64, 95 % CI 1.27-2.13) and women (OR 1.38, 95 % CI 1.04-1.82) in the risk of melanoma. In addition, we found the risk of non-melanoma skin cancers in PD was slightly higher (OR 1.20, 95 % CI 1.11-1.29) than general population. It was impossible to evaluate the association between PD and melanoma according to use of levodopa or gene polymorphism via meta-analysis since few observational or cohort studies have focused on it.

Conclusions: An association between PD and melanoma was confirmed. Most of the evidences were of high quality, and the conclusion was robust. Further research is needed to explore the mechanisms underlying this relationship.

No MeSH data available.


Related in: MedlinePlus