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Number of parity and the risk of gallbladder cancer: a systematic review and dose–response meta-analysis of observational studies

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Current epidemiological evidence suggests an association between parity and risk of gallbladder cancer (GBC), but studies have yielded inconsistent conclusions.

Objective

The purpose of this meta-analysis is to systematically analyze the effect of the number of parity on GBC risk.

Methods

We searched Web of Science, EMBASE, PubMed, China Biological Medicine Database from inception to the end of April 2015. Studies investigating parity and risk of GBC were included. A systematic review and a dose–response meta-analysis were performed to investigate the association between parity and GBC risk using odds ratios (OR) and 95 % confidence intervals (CI).

Results

Thirteen case–control studies were eligible for inclusion in this meta-analysis, including a total of 2,164 cases and 11,340 controls. A significant association was identified for the ever parity vs. nulliparous at 1.39 (95 % CI 1.15–1.68; Power = 0.73; I 2 = 0.0 %; P = 0.90). Similarly, the summary estimate for high vs. low parity number was 1.86 (95 % CI 1.51–2.30; Power = 0.26; I 2 = 66.0 %; P < 0.01). For the dose–response relationship, a non-linear association between the parity number and GBC risk was not observed (P non-linearity = 0.578), but a clear linear relationship was detected. The combined odds ratio of GBC for an increase in parity of one live birth was 1.12 (95 % CI 1.09–1.21; Power = 0.99; I 2 = 39.9 %; P = 0.139). Subgroup and sensitivity analyses showed similar associations. No publication bias was found in all results. Significant heterogeneity between subgroups was detected by meta-regression analyses.

Conclusions

In females, higher parity may be associated with an increased risk of gallbladder cancer. In the future, high-quality cohort studies with larger sample sizes and randomized controlled trials are needed to fully scrutinize this association.

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    Authors and Affiliations

    1. General Surgery, The Third Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, 98 Fenghuangbei Road, Zunyi, 563000, China

      Peng Guo & ChunLin Feng

    2. Department of Urology, Zhongnan Hospital of Wuhan University, Center of Evidence Based and Transformation Medicine of Wuhan University, Wuhan, 430071, China

      Chang Xu

    3. Department of Science and Education, First People’s Hospital of Changde City, Changde, 415003, China

      Quan Zhou

    4. Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, 563000, China

      JianGuo Zhou

    5. Department of Immunity, Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, 563000, China

      JuanJuan Zhao

    6. Institute of Public Health, Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, 563099, China

      ZhuangLi Si

    7. College of Medicine and Nursing of HuBei Medical University, HuBei Medical University, Shiyan, 442200, China

      Cheng Shen

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    1. Peng Guo
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    P. Guo, C. Xu and Q. Zhou have contributed equally.

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    Guo, P., Xu, C., Zhou, Q. et al. Number of parity and the risk of gallbladder cancer: a systematic review and dose–response meta-analysis of observational studies. Arch Gynecol Obstet 293, 1087–1096 (2016). https://doi.org/10.1007/s00404-015-3896-6

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