The Aetiological Role of Human Papillomavirus in Oesophageal Squamous Cell Carcinoma: A Meta-Analysis

SUMMARYHigh-risk human papillomaviruses (HPVs) cause essentially all cervical cancers, most anal and oropharyngeal cancers, and some vaginal, vulvar, and penile cancers. Improved understanding of the pathogenesis of infection and the availability of newer tests are changing the approach to screening and diagnosis. Molecular tests to detect DNA from the most common high-risk HPVs are FDA approved for use in conjunction with cytology in cervical cancer screening programs. More-specific tests that detect RNA from high-risk HPV types are now also available. The use of molecular tests as the primary screening tests is being adopted in some areas. Genotyping to identify HPV16 and -18 has a recommended role in triaging patients for colposcopy who are high-risk HPV positive but have normal cytology. There are currently no recommended screening methods for anal, vulvar, vaginal, penile, or oropharyngeal HPV infections. HPV testing has limited utility in patients at high risk for anal cancer, but p16 immunohistochemistry is recommended to clarify lesions in tissue biopsy specimens that show moderate dysplasia or precancer mimics. HPV testing is recommended for oropharyngeal squamous cell tumors as a prognostic indicator. Ongoing research will help to improve the content of future guidelines for screening and diagnostic testing.

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“…HPV has also been detected in esophageal tissue and is associated with a 3-fold-greater chance of esophageal squamous cell carcinoma (39).…”

Section: Oropharyngeal Cancermentioning

confidence: 99%

Human Papillomavirus Laboratory Testing: the Changing Paradigm

2016

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“…Numerous case-control studies have reported positive associations with ESCC [87,88]; however, more recent studies conducted under sterile conditions with very careful ascertainment of tumor tissue have failed to replicate those earlier findings [89,90]. Large-scale serologic analyses pooling data from diverse populations have also failed to demonstrate consistently that cases have higher antibody titers than control subjects [91].…”

Section: Infectionmentioning

confidence: 95%

Esophageal Cancer: Priorities for Prevention

Whiteman

2014

Curr Epidemiol Rep

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Making a sizeable contribution to worldwide cancer mortality, adenocarcinomas and squamous cell carcinomas of the esophagus appear to be caused largely by environmental factors. Descriptive epidemiologic analyses demonstrate that these cancers occur at markedly different rates in populations around the world. Moreover, their incidences have changed greatly over time, strongly suggesting that their causes are modifiable. For adenocarcinomas, the risk factors identified consistently in analytic studies include gastroesophageal acid reflux, obesity, smoking, and male sex. Squamous cell carcinomas in Western countries have been attributed largely to smoking, high levels of alcohol consumption, and poor nutrition. In other parts of the world, poor-quality diets, thermal injury, exposure to polycyclic aromatic hydrocarbons, and poor oral health have been implicated. Prevention strategies targeting these exposures offer a logical foundation for action, although the outcomes of prevention trials have been frustratingly ineffective to date. Novel approaches to early detection are currently under development and may prove useful for disease control in high-incidence settings.

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“…OR indicates odds ratio. Reprinted from Liyanage et al 79 Copyright © 2013, The Authors. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.…”

Section: Clinical Statements and Guidelinesmentioning

confidence: 99%

Methodological Standards for Meta-Analyses and Qualitative Systematic Reviews of Cardiac Prevention and Treatment Studies: A Scientific Statement From the American Heart Association

Rao¹,

López-Jiménez²,

Boyd³

et al. 2017

Circulation

194

111

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Meta-analyses are becoming increasingly popular, especially in the fields of cardiovascular disease prevention and treatment. They are often considered to be a reliable source of evidence for making healthcare decisions. Unfortunately, problems among meta-analyses such as the misapplication and misinterpretation of statistical methods and tests are long-standing and widespread. The purposes of this statement are to review key steps in the development of a metaanalysis and to provide recommendations that will be useful for carrying out meta-analyses and for readers and journal editors, who must interpret the findings and gauge methodological quality. To make the statement practical and accessible, detailed descriptions of statistical methods have been omitted. Based on a survey of cardiovascular metaanalyses, published literature on methodology, expert consultation, and consensus among the writing group, key recommendations are provided. Recommendations reinforce several current practices, including protocol registration; comprehensive search strategies; methods for data extraction and abstraction; methods for identifying, measuring, and dealing with heterogeneity; and statistical methods for pooling results. Other practices should be discontinued, including the use of levels of evidence and evidence hierarchies to gauge the value and impact of different study designs (including meta-analyses) and the use of structured tools to assess the quality of studies to be included in a metaanalysis. We also recommend choosing a pooling model for conventional meta-analyses (fixed effect or random effects) on the basis of clinical and methodological similarities among studies to be included, rather than the results of a test for statistical heterogeneity. CLINICAL STATEMENTS AND GUIDELINES D espite the increasing popularity of meta-analyses and systematic reviews in general, problems with methodology are widespread and frequently undermine the credibility of the results. New guidance is needed for both researchers who carry out meta-analyses and systematic reviews in general and the consumers who read them and rely on the results. The term meta-analysis was coined in 1976 by the American statistician Gene Glass, who wrote, "I use it to refer to the statistical analysis of a large collection of results from individual studies for the purpose of integrating findings. It connotes a rigorous alternative to the casual, narrative discussions of research studies which typify our attempts to make sense of the rapidly expanding literature."1 Meta-analyses are a subcategory of the broader category of studies known as systematic reviews.Qualitative systematic reviews include explicit and detailed methods for identification, selection, and grading the quality of individual studies and overall evidence but do not pool results across studies. Meta-analysis is synonymous with the term quantitative systematic review and by definition includes pooling of results across studies. The emphasis in this statement is on metaanalysis bec...

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The Aetiological Role of Human Papillomavirus in Oesophageal Squamous Cell Carcinoma: A Meta-Analysis

Cited by 68 publications

References 36 publications

Human Papillomavirus Laboratory Testing: the Changing Paradigm

Human Papillomavirus Laboratory Testing: the Changing Paradigm

Esophageal Cancer: Priorities for Prevention

Methodological Standards for Meta-Analyses and Qualitative Systematic Reviews of Cardiac Prevention and Treatment Studies: A Scientific Statement From the American Heart Association

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