The prevalence of human papillomavirus in colorectal adenomas and adenocarcinomas: A systematic review and meta-analysis
A partir d'une revue systématique de la littérature, cette méta-analyse évalue la prévalence d'une infection par le papillomavirus humain dans des adénomes et adénocarcinomes colorectaux et analyse l'association entre cette infection et le risque de cancer colorectal
The role of human papillomavirus (HPV) in colorectal cancer has been widely studied with conflicting results. We performed a systematic review and a meta-analysis to estimate the prevalence of HPV in colorectal adenocarcinomas and adenomas, and test the potential association. The pooled HPV prevalence was estimated using a random effects model and the I2 statistic was used to describe the amount of heterogeneity. Potential sources of heterogeneity were evaluated by meta-regression and stratified analyses. For the studies on adenocarcinomas including control tissue, random effects estimates of odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Thirty-seven studies were included. Among the 2630 adenocarcinomas, the pooled HPV prevalence was 11.2% (95% CI, 4.9–19.6%) with substantial between-study heterogeneity (I2=97.2%). The HPV prevalence varied by geographical region with highest prevalence in South America (45.1%, 95% CI, 21.9–69.4%), Asia (39.2%, 95% CI, 20.3–60.0%) and the Middle East (32.2%, 95% CI, 1.1–79.3%), and by detection method with the highest HPV prevalence in PCR-based studies. In the eight case–control studies, the pooled HPV prevalence was 36.8% (95% CI, 21.3–53.8%) in adenocarcinomas and 1.6% (95% CI, 0.0–9.6%) in controls giving an OR of 6.0 (95% CI, 2.0–17.9%) for the association between HPV and colorectal cancer. Among the 415 adenomas, the pooled HPV prevalence was 5.1% (95% CI, 0.0–17.8%; I2=93.7%). HPV may be associated with a subset of colorectal cancers. Future large-scale multicenter case–control studies with data on risk factors such as lifestyle and sexual behaviour are needed.
http://linkinghub.elsevier.com/retrieve/pii/S0959804914000926?showall=true