Trichomonas vaginalis infection is associated with increased risk of cervical carcinogenesis: A systematic review and meta‐analysis of 470 000 patients

Abstract

BackgroundTrichomonas vaginalis infection is the most prevalent non‐viral sexually transmitted infection (STI) in women and has been suggested as a risk factor for developing cervical cancer.ObjectiveWe aimed to investigate the associations between T. vaginalis infection and cervical carcinogenesis.Search StrategyA comprehensive systematic search was conducted in five databases on 21 October 2021.Selection CriteriaStudies assessing the relationship between T. vaginalis infection, HPV co‐infections, cervical dysplasia, and cervical cancer were found eligible.Data Collection and AnalysisSummary estimates for pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated with a random‐effects model. Statistical heterogeneity was measured with I2 and Cochran's Q tests.Main ResultsThe 29 articles included 473 740 women, of whom 8518 were T. vaginalis‐positive. Our results showed that T. vaginalis‐infected women had 1.79 times higher odds of being diagnosed with HPV co‐infection (95% CI 1.27–2.53; I2 95%). We also found that T. vaginalis infection was associated with high‐grade squamous intraepithelial lesion diagnosis (OR 2.34, 95% CI 1.10–4.95; I2 75%) and cervical cancer (OR 5.23, 95% CI 3.03–9.04; I2 3%).ConclusionsOur results showed an association between T. vaginalis and cervical carcinogenesis in sexually active women.

HPV co‐infections with other pathogens in cancer development: A comprehensive review

“…Prolonged inflammation exposes the tissue to ongoing genotoxic effects, leading to different forms of cancers. 191 Chronic inflammation can also accelerate the development of cervical cancer as well as the initial alterations caused by HR-HPVs. 192,193 Multiple studies have proven that women with a specific cervicovaginal microbiota composition may be more likely to acquire HPV or to show a faster progression to CN.…”

“…In cases of HPV infection, inflammation of the cervix can act as a co‐factor for severe lesions. Prolonged inflammation exposes the tissue to ongoing genotoxic effects, leading to different forms of cancers 191 . Chronic inflammation can also accelerate the development of cervical cancer as well as the initial alterations caused by HR‐HPVs 192,193 .…”

“…It also can increase the risk of cervical cancer by developing an inflammatory environment through production of nitric oxide (NO) by neutrophils in the cervix, which enhances DNA damage, growth of abnormal cells, HPV entrance, and persistence 220 . TV infection can overexpress viral tumorigenesis which helps activation of cancer‐causing pathways 191 . On the other hand, CT has received more research interest as the most important pathogen associated with HPV infection compared to other cervicovaginal bacterial agents.…”

“…220 TV infection can overexpress viral tumorigenesis which helps activation of cancer-causing pathways. 191 On the other hand, CT has received more research interest as the most important pathogen associated with HPV infection compared to other cervicovaginal bacterial agents. Figure 2 indicates the effects of C. trachomatis infection and microbiome dysbiosis with HR-HPVs in cancer development.…”

Prevalence of Trichomonas Infection in Relation to Human Papillomavirus (HPV) in Pap Smear Samples of Female Patients Referred to Shahid Sadoughi Hospital, Yazd (Iran)

“…These microorganisms induce chronic inflammation and have the potential to function as carcinogens through the induction of substantial cellular and molecular alterations. DNA damage and repair inhibition may result from the proliferation, recruitment, and increased production of reactive oxygen species (ROS) during the inflammatory process [ 12 ]. STIs induce alterations in the cervical epithelium that render it susceptible to mutation.…”