The risk of malignancy in patients with IgG4-related disease: a systematic review and meta-analysis

Abstract Background The relationship between IgG4-related disease (IgG4-RD) and the risk of malignancy is still controversial. This article focused on assessing the risk of cancer in patients with IgG4-RD by meta-analysis. Methods We conducted a systematic review of the literature and meta-analysis characterizing the associated risk of overall malignancy and four site-specific malignancies (pancreas, lung, gastric and lymphoma) in patients with IgG4-RD. A search from 2003 to 2020 was performed using specified terms from PubMed, Embase, Web of Science and SinoMed. Random-effects model analysis was used to pool standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were conducted to clarify the heterogeneity of the included studies. Begg’s funnel plot and Egger’s linear regression test were used to evaluate the bias of the meta-analysis. A P value < 0.05 indicated the existence of publication bias. Results A total of 10 studies were included in the article. The overall SIR estimates suggested an increased risk of overall cancer in IgG4-RD patients (SIR 2.57 95% CI 1.72–3.84) compared with the general population. The specific SIRs for pancreas and lymphoma were higher than those of the general population in IgG4-RD patients (SIR 4.07 95% CI 1.04–15.92, SIR 69.17 95% CI 3.91–1223.04, respectively). No significant associations were revealed in respiratory and gastric cancer (SIR 2.14 95% CI 0.97–4.75, SIR 0.95 95% CI 0.24–3.95, respectively). Four studies were found to be the major sources of heterogeneity by sensitivity analysis. There was no evidence of publication bias via Egger’s test. Conclusion Compared with the general population, patients with IgG4-RD appear to have a higher risk of overall cancer, especially pancreatic and lymphoma. The risk of lung and gastric cancer was not different between IgG4-RD patients and the general population.

Download Full-text

Cancer mortality in patients with schizophrenia: systematic review and meta-analysis

The British Journal of Psychiatry ◽

10.1192/bjp.bp.116.195776 ◽

2017 ◽

Vol 211 (1) ◽

pp. 7-13 ◽

Cited By ~ 27

Author(s):

Chuanjun Zhuo ◽

Ran Tao ◽

Ronghuan Jiang ◽

Xiaodong Lin ◽

Mingjing Shao

Keyword(s):

Systematic Review ◽

General Population ◽

Cancer Mortality ◽

Meta Analysis ◽

The Other ◽

Random Effects Model ◽

Hazard Ratios ◽

Increased Risk ◽

Standardised Mortality Ratios ◽

Risk Of Cancer

BackgroundPrevious studies have reported conflicting results on the association between schizophrenia and cancer mortality.AimsTo summarise available evidence and quantify the association between schizophrenia and cancer mortality using meta-analysis.MethodWe systematically searched literature in the PubMed and Embase databases. Risk estimates and 95% confidence intervals reported in individual studies were pooled using the DerSimonian–Laird random-effects model.ResultsWe included 19 studies in the meta-analysis. Among them, 15 studies reported standardised mortality ratios (SMRs) comparing patients with schizophrenia with the general population, and the pooled SMR was 1.40 (95% CI 1.29–1.52, P<0.001). The other four studies reported hazard ratios (HRs) comparing individuals with schizophrenia with those without schizophrenia; the pooled HR was 1.51 (95% CI 1.13–2.03, P = 0.006).ConclusionsPatients with schizophrenia are at a significantly increased risk of cancer mortality compared with the general population or individuals without schizophrenia.

Download Full-text

Systematic review and meta-analysis of female lifestyle factors and risk of recurrent pregnancy loss

Scientific Reports ◽

10.1038/s41598-021-86445-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ka Ying Bonnie Ng ◽

George Cherian ◽

Alexandra J. Kermack ◽

Sarah Bailey ◽

Nick Macklon ◽

...

Keyword(s):

Systematic Review ◽

General Population ◽

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Meta Analysis ◽

Lifestyle Factors ◽

Caffeine Intake ◽

Increased Risk ◽

Secondary Outcomes

AbstractIt is known that lifestyle factors affect sporadic miscarriage, but the extent of this on RPL (recurrent pregnancy loss) is less well known. A systematic review and meta-analysis was performed to assess the associations between lifestyle factors and RPL. Studies that analysed RPL in the context of BMI, smoking, alcohol and caffeine intake were included. The primary and secondary outcomes were odds of having RPL in the general population and odds of further miscarriage, respectively. Underweight and women with BMI > 25 are at higher odds of RPL in the general population (OR 1.2, 95% CI 1.12–1.28 and OR 1.21, 95% CI 1.06–1.38, respectively). In women with RPL, having BMI > 30 and BMI > 25 has increased odds of further miscarriages (OR 1.77, 95% CI 1.25–2.50 and OR 1.35, 95% CI 1.07–1.72, respectively). The quality of the evidence for our findings was low or very low. Being underweight and BMI > 25 contributes significantly to increased risk of RPL (general population). BMI > 25 or BMI > 30 increases the risk of further miscarriages (RPL population). Larger studies addressing the effects of alcohol, cigarette smoking and caffeine on the risk of RPL with optimisation of BMI in this cohort of women are now needed.

Download Full-text

Association between Oral Contraceptives and cutaneous melanoma: a systematic review and metanalysis

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1093 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Giacchetta ◽

M Chiavarini ◽

G Naldini ◽

R Fabiani

Keyword(s):

Systematic Review ◽

Malignant Melanoma ◽

Publication Bias ◽

Oral Contraceptives ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cutaneous Malignant Melanoma ◽

Hormonal Factors ◽

Increased Risk

Abstract Background The probability of developing invasive cutaneous malignant melanoma (CMM) is higher in women than in men up until the age of 49. Several studies investigated the association between hormonal factors and CMM. The aim of this systematic review and meta-analysis is to summarize the evidence on the association between Oral Contraceptives (OC) and the risk of CMM. Methods This review and meta-analysis follow the PRISMA guidelines. A systematic literature search was conducted on Medline and Web of Science until December 2019. Studies were eligible if reported a risk estimate for the association between OC and CMM. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger's test and Begg's test. Meta-analysis was performed using random effect model. Results The results of the pooled analysis of all 32 studies showed no significant association between OC and the risk of CMM (OR 1.02; 95% CI 0.94-1.11; I2=39.32%, p = 0.013). The stratified analyses by study design found no significant association between OC and the risk of CMM neither in the 18 case-control studies (OR 1.02; 95% CI 0.87-1.21; I2=56.91%, p = 0.002) nor in the 14 cohort studies (OR 1.04; 95% CI 0.98-1.11; I2=0.00%, p = 0.557). No significant publication bias could be detected by Egger's test or Begg's test. Conclusions This meta-analysis of available literature suggests no significant association between OC and the risk of developing CMM. Further investigations are needed to evaluate the possible relationship of OC use and other hormonal factors potentially contributing to the increased risk of CMM in women during their reproductive years. Key messages Oral contraceptives (OC) do not significantly contribute to the risk of Cutaneous Malignant Melanoma (CMM). Further studies are needed to investigate the potential role of other hormonal factors in the increased probability of developing CMM in women during their reproductive years.

Download Full-text

Psychotic experiences and risk of self-injurious behaviour in the general population: a systematic review and meta-analysis

Psychological Medicine ◽

10.1017/s0033291715001841 ◽

2015 ◽

Vol 46 (2) ◽

pp. 237-251 ◽

Cited By ~ 36

Author(s):

S. Honings ◽

M. Drukker ◽

R. Groen ◽

J. van Os

Keyword(s):

Systematic Review ◽

General Population ◽

Meta Analysis ◽

Full Range ◽

Effect Sizes ◽

Psychotic Experiences ◽

Increased Risk ◽

Self Harm ◽

Specific Association ◽

Residual Confounding

BackgroundRecent studies suggest that psychotic experiences (PE) in the general population are associated with an increased risk of self-injurious behaviour. Both the magnitude of this association and the level of adjustment for confounders vary among studies. A meta-analysis was performed to integrate the available evidence. The influence of possible confounders, including variably defined depression, was assessed.MethodA systematic review and meta-analysis was conducted including general population studies reporting on the risk of self-injurious behaviour in individuals with PE. Studies were identified by a systematic search strategy in Pubmed, PsycINFO and Embase. Reported effect sizes were extracted and meta-analytically pooled.ResultsThe risk of self-injurious behaviour was 3.20 times higher in individuals with PE compared with those without. Subanalyses showed that PE were associated with self-harm, suicidal ideation as well as suicidal attempts. All studies had scope for considerable residual confounding; effect sizes adjusted for depression were significantly smaller than effect sizes unadjusted for depression. In the longitudinal studies, adjustment for psychopathology resulted in a 74% reduction in excess risk.ConclusionsPE are associated with self-injurious behaviour, suggesting they have potential as passive markers of suicidality. However, the association is confounded and several methodological issues remain, particularly how to separate PE from the full range of connected psychopathology in determining any specific association with self-injurious behaviour. Given evidence that PE represent an indicator of severity of non-psychotic psychopathology, the association between PE and self-injurious behaviour probably reflects a greater likelihood of self-injurious behaviour in more severe states of mental distress.

Download Full-text

Significantly Increased Risk of Cancer in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis

Endocrine Practice ◽

10.4158/ep10357.ra ◽

2011 ◽

Vol 17 (4) ◽

pp. 616-628 ◽

Cited By ~ 84

Author(s):

Hiroshi Noto ◽

Tetsuro Tsujimoto ◽

Takehiko Sasazuki ◽

Mitsuhiko Noda

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Meta Analysis ◽

Increased Risk ◽

Patients With Diabetes ◽

Risk Of Cancer

Download Full-text

Pregnancy After Breast Cancer: A Systematic Review and Meta-Analysis

Journal of Clinical Oncology ◽

10.1200/jco.21.00535 ◽

2021 ◽

pp. JCO.21.00535

Author(s):

Matteo Lambertini ◽

Eva Blondeaux ◽

Marco Bruzzone ◽

Marta Perachino ◽

Richard A. Anderson ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

General Population ◽

Meta Analysis ◽

Disease Free Survival ◽

Subsequent Pregnancy ◽

Care Plan ◽

Survivorship Care Plan ◽

Reproductive Outcomes ◽

Increased Risk

PURPOSE Many patients and physicians remain concerned about the potential detrimental effects of pregnancy after breast cancer (BC) in terms of reproductive outcomes and maternal safety. This systematic review and meta-analysis aimed at providing updated evidence on these topics. METHODS A systematic literature review was conducted to identify studies including patients with a pregnancy after BC (PROSPERO number CRD42020158324). Likelihood of pregnancy after BC, their reproductive outcomes, and maternal safety were assessed. Pooled relative risks, odds ratios (ORs), and hazard ratios (HRs) with 95% CIs were calculated using random effects models. RESULTS Of 6,462 identified records, 39 were included involving 8,093,401 women from the general population and 112,840 patients with BC of whom 7,505 had a pregnancy after diagnosis. BC survivors were significantly less likely to have a subsequent pregnancy compared with the general population (relative risk, 0.40; 95% CI, 0.32 to 0.49). Risks of caesarean section (OR, 1.14; 95% CI, 1.04 to 1.25), low birth weight (OR, 1.50; 95% CI, 1.31 to 1.73), preterm birth (OR, 1.45; 95% CI, 1.11 to 1.88), and small for gestational age (OR, 1.16; 95% CI, 1.01 to 1.33) were significantly higher in BC survivors, particularly in those with previous chemotherapy exposure, compared with the general population. No significantly increased risk of congenital abnormalities or other reproductive complications were observed. Compared to patients with BC without subsequent pregnancy, those with a pregnancy had better disease-free survival (HR, 0.66; 95% CI, 0.49 to 0.89) and overall survival (HR, 0.56; 95% CI, 0.45 to 0.68). Similar results were observed after correcting for potential confounders and irrespective of patient, tumor, and treatment characteristics, pregnancy outcome, and timing of pregnancy. CONCLUSION These results provide reassuring evidence on the safety of conceiving in BC survivors. Patients' pregnancy desire should be considered a crucial component of their survivorship care plan.

Download Full-text

The risk of infections in adult patients with systemic lupus erythematosus: systematic review and meta-analysis

Rheumatology ◽

10.1093/rheumatology/keaa478 ◽

2020 ◽

Vol 60 (1) ◽

pp. 60-72 ◽

Cited By ~ 1

Author(s):

José María Pego-Reigosa ◽

Lindsay Nicholson ◽

Nick Pooley ◽

Sue Langham ◽

Nina Embleton ◽

...

Keyword(s):

Systematic Review ◽

Herpes Zoster ◽

General Population ◽

Meta Analysis ◽

Severe Infection ◽

Infection Risk ◽

Sensitivity Analyses ◽

Healthy Controls ◽

Increased Risk ◽

The Impact

Abstract Objectives We conducted a systematic review and meta-analysis to determine the magnitude of infection risk in patients with SLE and evaluate the effect of general and SLE-related factors on infection risk. Methods We searched MEDLINE and Embase from inception to July 2018, screening for observational studies that evaluated infection risk in patients with SLE compared with the general population/healthy controls. Outcomes of interest included overall severe infection, herpes zoster infection/reactivation, opportunistic infections, pneumonia and tuberculosis. Random-effects models were used to calculate pooled risk ratios (RRs) for each type of infection. Sensitivity analysis assessed the impact of removing studies with high risk of bias. Results Eleven retrospective or prospective cohort studies were included in the meta-analysis: overall severe infection (n = 4), pneumonia (n = 6), tuberculosis (n = 3) and herpes zoster (n = 2). Pooled RRs for overall severe infection significantly increased for patients with SLE compared with the general population/healthy controls [RR 2.96 (95% CI 1.28, 6.83)]. Pooled RRs for pneumonia, herpes zoster and tuberculosis showed significantly increased risk compared with the general population/healthy controls [RR 2.58 (1.80, 3.70), 2.50 (2.36, 2.65) and 6.11 (3.61, 10.33), respectively]. Heterogeneity and evidence of publication bias were present for all analyses, except herpes zoster. Sensitivity analyses confirmed robustness of the results. Conclusion Patients with SLE have significantly higher risk of infection compared with the general population/healthy controls. Efforts to strengthen strategies aimed at preventing infections in SLE are needed. Protocol registration PROSPERO number: CRD42018109425.

Download Full-text

A Meta-Analysis of Obesity and Risk of Colorectal Cancer in Patients with Lynch Syndrome: The Impact of Sex and Genetics

Nutrients ◽

10.3390/nu13051736 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1736

Author(s):

Matteo Lazzeroni ◽

Federica Bellerba ◽

Mariarosaria Calvello ◽

Finlay Macrae ◽

Aung Ko Win ◽

...

Keyword(s):

Colorectal Cancer ◽

Lynch Syndrome ◽

Publication Bias ◽

Colorectal Neoplasia ◽

Meta Analysis ◽

Random Effect ◽

Normal Weight ◽

Increased Risk ◽

Risk Of Cancer ◽

The Impact

There appears to be a sex-specific association between obesity and colorectal neoplasia in patients with Lynch Syndrome (LS). We meta-analyzed studies reporting on obesity and colorectal cancer (CRC) risk in LS patients to test whether obese subjects were at increased risk of cancer compared to those of normal weight. We explored also a possible sex-specific relationship between adiposity and CRC risk among patients with LS. The summary relative risk (SRR) and 95% confidence intervals (CI) were calculated through random effect models. We investigated the causes of between-study heterogeneity and assessed the presence of publication bias. We were able to retrieve suitable data from four independent studies. We found a twofold risk of CRC in obese men compared to nonobese men (SRR = 2.09; 95%CI: 1.23–3.55, I2 = 33%), and no indication of publication bias (p = 0.13). No significantly increased risk due to obesity was found for women. A 49% increased CRC risk for obesity was found for subjects with an MLH1 mutation (SRR = 1.49; 95%CI: 1.11–1.99, I2 = 0%). These results confirm the different effects of sex on obesity and CRC risk and also support the public measures to reduce overweight in people with LS, particularly for men.

Download Full-text

Secondary Leukemia After Non-Hodgkin Lymphoma: A Systematic Review and a Meta-Analysis

Blood ◽

10.1182/blood.v118.21.5192.5192 ◽

2011 ◽

Vol 118 (21) ◽

pp. 5192-5192

Author(s):

Raffaella Marcheselli ◽

Alessia Bari ◽

Eliana Valentina Liardo ◽

Luigi Marcheselli ◽

Samantha Pozzi ◽

...

Keyword(s):

Systematic Review ◽

Hodgkin Lymphoma ◽

Publication Bias ◽

Observational Studies ◽

Conflicts Of Interest ◽

Meta Analysis ◽

Group Analysis ◽

Secondary Leukemia ◽

Non Hodgkin Lymphoma ◽

Increased Risk

Abstract Abstract 5192 Background: The risk of second leukemia/myelodisplastic syndrome (MDS) in non-Hodgkin lymphoma (NHL) survivors has been described in several studies, but the available evidence has yielded different results. Thus, we performed a systematic review and a meta-analysis on population-based and cohort studies to provide a quantitative assessment of the risk of secondary leukemia/MDS after NHL. Aims of our research were to estimate the pooled Relative Risk (RR) of secondary leukemia/MDS and the RRs associated with impact of different therapies in particular the effect of radiation treatments. Methods: A Medline search of articles published between January 1985 and December 2010 was conducted to identify relevant observational studies. We included studies that met each of the following criteria: 1) published in English-language; 2) original papers (no reviews, comments, letters, or editorials); 3) including naïve patients with any stage of NHL; 4) investigating the risk of secondary leukemia/MDS in NHL survivors; 5) reporting RR, specified as standardized incidence ratios or data allowing such outcomes to be derived. The reference lists of the selected articles were inspected to identify additional papers. When two or more articles reported duplicate data, we included the most recently updated data or most informative study. We did not exclude papers on the base of therapeutic regimens. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. Pooled RR and 95% confidence interval (CI) were calculated using random effect models. Meta-regression and tests on heterogeneity and sensitivity analysis was conducted. The publication bias was also evaluated. Results: Fifteen papers met the inclusion criteria reporting RRs for leukemia/MDS. These studies included 278,782 patients affected by NHL of which 575 presented a second leukemia/MDS. RRs ranged from 2.0–251.8 and we found a meta-RR for secondary leukemia/MDS of 8.69 (95%CI: 3.66–20.64). In addition, we evaluated the effect of therapeutic regimens and radiotherapy (RT) and/or total body irradiation (TBI) exposure, limiting the analysis to the studies that clearly described the chemotherapies (CHT) and RT and/or TBI. We found a significant increased risk of second leukemia/MDS for patients exposed to irradiation (considering studies where the % of patients treated with RT and/or TBI was >30%) in comparison with unexposed patients: meta-RR was 20.20 (95%CI: 4.65–87.89) and 6.48 (95%CI:2.41–17.39) respectively. By regression analysis we identified a significant association between RT and/or TBI and secondary leukemia/MDS (P=0.004). No publication bias was observed. Regarding CHT with alkylating agents we found a meta-RR of 9.83 (95%CI: 2.45–58.84), and in a sub-group analysis of the studies that reported informations of CHT plus RT in comparison with the studies that reported data of CHT alone we found an increased risk for the patients undergoing CHT plus RT: meta-RR 13.35 (95%CI: 1.75–19.46) and 5.83 (95%CI: 1.75–19.46) respectively. Conclusion: Our comparative analysis on the incidence of second leukemia/MDS presents several issues including the heterogeneity of NHL, the source of data, the time during which the studies were performed, the different schedule of CHT, the dose of RT used in the different period of time and the length of follow-up. Although these problems could reduce the accuracy of the meta-analysis, our results indicate that NHL treatment is associated with a significantly higher risk of second leukemia/MDS, in particular after RT and/or TBI. Disclosures: No relevant conflicts of interest to declare. Acknowledgments: the study has been supported by funds of the Italian Ministry of Education (FIRB 2011, CINECA code RBAP11TF7Z) and the Italian Association “Angela Serra per la Ricerca sul Cancro”, Modena. Disclosures: No relevant conflicts of interest to declare.

Download Full-text

Use of Antibiotics and Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies

Cancers ◽

10.3390/cancers11081174 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1174 ◽

Cited By ~ 8

Author(s):

Fausto Petrelli ◽

Michele Ghidini ◽

Antonio Ghidini ◽

Gianluca Perego ◽

Mary Cabiddu ◽

...

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Meta Analysis ◽

Antibiotic Use ◽

Cochrane Library ◽

Cancer Occurrence ◽

Incident Cancer ◽

Increased Risk ◽

The Cochrane Library ◽

Risk Of Cancer

The association between antibiotic use and risk of cancer development is unclear, and clinical trials are lacking. We performed a systematic review and meta-analysis of observational studies to assess the association between antibiotic use and risk of cancer. PubMed, the Cochrane Library and EMBASE were searched from inception to 24 February 2019 for studies reporting antibiotic use and subsequent risk of cancer. We included observational studies of adult subjects with previous exposure to antibiotics and available information on incident cancer diagnoses. For each of the eligible studies, data were collected by three reviewers. Risk of cancer was pooled to provide an adjusted odds ratio (OR) with a 95% confidence interval (CI). The primary outcome was the risk of developing cancer in ever versus non-antibiotic users. Cancer risk’s association with antibiotic intake was evaluated among 7,947,270 participants (n = 25 studies). Overall, antibiotic use was an independent risk factor for cancer occurrence (OR 1.18, 95%CI 1.12–1.24, p < 0.001). The risk was especially increased for lung cancer (OR 1.29, 95%CI 1.03–1.61, p = 0.02), lymphomas (OR 1.31, 95%CI 1.13–1.51, p < 0.001), pancreatic cancer (OR 1.28, 95%CI 1.04–1.57, p = 0.019), renal cell carcinoma (OR 1.28, 95%CI 1.1–1.5, p = 0.001), and multiple myeloma (OR 1.36, 95%CI 1.18–1.56, p < 0.001). There is moderate evidence that excessive or prolonged use of antibiotics during a person’s life is associated with slight increased risk of various cancers. The message is potentially important for public health policies because minimizing improper antibiotic use within a program of antibiotic stewardship could also reduce cancer incidence.

Download Full-text