Is Trichomonas vaginalis a cause of cervical neoplasia? Results from a combined analysis of 24 studies Journal Article


Authors: Zhang, Z. F.; Begg, C. B.
Article Title: Is Trichomonas vaginalis a cause of cervical neoplasia? Results from a combined analysis of 24 studies
Abstract: Background. We conducted this combined analysis of available data from studies with information on this issue to clarify the association between Trichomonas vaginalis infection and cervical neoplasia. MethodsWe performed MEDLINE searches (1966—1993) uslng the key words and phrases trichomonas vaginitis and neoplasms, cervix for articles published in English, and searched citations of the articles obtained from MEDLINE. A total of 24 articles (two cohort studies and 22 case-control) were included in this data analysis. In the analysis, the studies were evaluated for heterogeneity using Breslow-Day tests for homogeneity of the odds ratios and of rate ratios. If the odds ratios from studies are heterogeneous, it is not appropriate to combine them using the Mantel-Haenszel method. Also, publication bias was evaluated by assessing the association between the observed effect size and the variance of the effect size using a rank correlation test. Results The combined summary relative risk for the two cohort studies was 1.93 (95% confidence interval: 1.22—2.65) indicating an approximate doubling of the risk of cervical neoplasia in the presence of T. vaginalis infection. The attributable risks among exposed subjects and among the source population were 47.4% and 2.1% respectively. Results of the 22 retrospective studies were much less consistent However, most of them demonstrated a significant positive association. ConclusionsThis combined analysis suggests that there is an association between T. vaginalis and the risk of cervical neoplasia, but that such infections account for only 2% of cervical neoplasia. © 1994 International Epidemiological Association.
Keywords: adolescent; adult; child; aged; aged, 80 and over; retrospective studies; major clinical study; clinical trial; neoplasm; neoplasms; cohort studies; biology; proportional hazards models; incidence; prevalence; cohort analysis; odds ratio; risk factors; data base; risk assessment; risk; confidence intervals; medical information; uterine cervix cancer; epidemiologic methods; data analysis; cross-sectional studies; bias (epidemiology); population surveillance; literature review; meta analysis; diseases; uterine cervix; cervical intraepithelial neoplasia; studies; middle age; case control studies; cervix neoplasms; causality; vaginitis; trichomonas vaginalis; cancer; human; female; priority journal; article; support, u.s. gov't, p.h.s.; trichomoniasis; trichomonas vaginitis; cervical cancer--etiology; vaginal abnormalities; effect modifiers (epidemiology)
Journal Title: International Journal of Epidemiology
Volume: 23
Issue: 4
ISSN: 0300-5771
Publisher: Oxford University Press  
Date Published: 1994-08-01
Start Page: 682
End Page: 690
Language: English
DOI: 10.1093/ije/23.4.682
PROVIDER: scopus
PUBMED: 8002180
DOI/URL:
Notes: Source: Scopus
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  1. Colin B Begg
    306 Begg
  2. Zuo-Feng Zhang
    102 Zhang