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Hypertension and the risk of endometrial cancer: a systematic review and meta-analysis of case-control and cohort studies

View Article: PubMed Central - PubMed

ABSTRACT

A history of hypertension has been associated with increased risk of endometrial cancer in several studies, but the results have not been consistent. We conducted a systematic review and meta-analysis of case-control and cohort studies to clarify the association between hypertension and endometrial cancer risk. PubMed and Embase databases were searched up to 27th of February 2016. Prospective and case-control studies which reported adjusted relative risk estimates and 95% confidence intervals of endometrial cancer associated with a hypertension diagnosis were included. Summary relative risks were estimated using a random effects model. Nineteen case-control studies and 6 cohort studies were included. The summary RR was 1.61 (95% CI: 1.41–1.85, I2 = 86%) for all studies, 1.73 (95% CI: 1.45–2.06, I2 = 89%) for case-control studies and 1.32 (95% CI: 1.12–1.56, I2 = 47%) for cohort studies. The association between hypertension and endometrial cancer was weaker, but still significant, among studies with adjustment for smoking, BMI, oral contraceptive use, and parity, compared to studies without such adjustment. This meta-analysis suggest an increased risk of endometrial cancer among patients with hypertension, however, further studies with more comprehensive adjustments for confounders are warranted to clarify the association.

No MeSH data available.


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Hypertension and endometrial cancer, funnel plot.
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f3: Hypertension and endometrial cancer, funnel plot.

Mentions: The summary RR for all studies was 1.61 (95% CI: 1.41–1.85, I2 = 86%), and it was 1.73 (95% CI: 1.45–2.06, I2 = 89%) for case-control studies and 1.32 (95% CI: 1.12–1.56, I2 = 47%) for cohort studies (Fig. 2), however, the test for heterogeneity by study design was not significant, p = 0.19. In sensitivity analyses excluding one study at a time the summary RR ranged from 1.49 (95% CI: 1.34–1.65) when excluding the study by Zhang et al.33 to 1.65 (95% CI: 1.41–1.94) when excluding the study by Trabert et al.36. There was evidence of publication bias with Egger’s test, p = 0.005 (Fig. 3), however, when stratified by study design this was observed among case-control studies, p = 0.007, but not among cohort studies, p = 0.78.


Hypertension and the risk of endometrial cancer: a systematic review and meta-analysis of case-control and cohort studies
Hypertension and endometrial cancer, funnel plot.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5384280&req=5

f3: Hypertension and endometrial cancer, funnel plot.
Mentions: The summary RR for all studies was 1.61 (95% CI: 1.41–1.85, I2 = 86%), and it was 1.73 (95% CI: 1.45–2.06, I2 = 89%) for case-control studies and 1.32 (95% CI: 1.12–1.56, I2 = 47%) for cohort studies (Fig. 2), however, the test for heterogeneity by study design was not significant, p = 0.19. In sensitivity analyses excluding one study at a time the summary RR ranged from 1.49 (95% CI: 1.34–1.65) when excluding the study by Zhang et al.33 to 1.65 (95% CI: 1.41–1.94) when excluding the study by Trabert et al.36. There was evidence of publication bias with Egger’s test, p = 0.005 (Fig. 3), however, when stratified by study design this was observed among case-control studies, p = 0.007, but not among cohort studies, p = 0.78.

View Article: PubMed Central - PubMed

ABSTRACT

A history of hypertension has been associated with increased risk of endometrial cancer in several studies, but the results have not been consistent. We conducted a systematic review and meta-analysis of case-control and cohort studies to clarify the association between hypertension and endometrial cancer risk. PubMed and Embase databases were searched up to 27th of February 2016. Prospective and case-control studies which reported adjusted relative risk estimates and 95% confidence intervals of endometrial cancer associated with a hypertension diagnosis were included. Summary relative risks were estimated using a random effects model. Nineteen case-control studies and 6 cohort studies were included. The summary RR was 1.61 (95% CI: 1.41–1.85, I2 = 86%) for all studies, 1.73 (95% CI: 1.45–2.06, I2 = 89%) for case-control studies and 1.32 (95% CI: 1.12–1.56, I2 = 47%) for cohort studies. The association between hypertension and endometrial cancer was weaker, but still significant, among studies with adjustment for smoking, BMI, oral contraceptive use, and parity, compared to studies without such adjustment. This meta-analysis suggest an increased risk of endometrial cancer among patients with hypertension, however, further studies with more comprehensive adjustments for confounders are warranted to clarify the association.

No MeSH data available.


Related in: MedlinePlus