Malene F. Svahn, Mette T. Faber, Bodil Norrild and Jane Christensen have stated explicitly that they have no conflicts of interest. Susanne K. Kjaer received lecture fees, advisory board fees, and research grants through her institution from Merck (manufacturer of the quadrivalent HPV vaccine) and Sanofi Pasteur MSD.
Prevalence of human papillomavirus in epithelial ovarian cancer tissue. A meta-analysis of observational studies
Article first published online: 24 OCT 2013
© 2013 Nordic Federation of Societies of Obstetrics and Gynecology
Acta Obstetricia et Gynecologica Scandinavica
Volume 93, Issue 1, pages 6–19, January 2014
How to Cite
Prevalence of human papillomavirus in epithelial ovarian cancer tissue. A meta-analysis of observational studies. Acta Obstet Gynecol Scand 2014; 93:6–19., , , , .
- Issue published online: 17 DEC 2013
- Article first published online: 24 OCT 2013
- Accepted manuscript online: 6 SEP 2013 09:15AM EST
- Manuscript Accepted: 25 AUG 2013
- Manuscript Received: 25 MAR 2013
- human papillomavirus;
- ovarian cancer;
The role of human papillomavirus (HPV) in the pathogenesis of ovarian cancer is controversial, and conflicting results have been published. We conducted a systematic review and meta-analysis to estimate the prevalence of HPV in epithelial ovarian cancer tissue.
Material and methods
Observational studies published until 4 March 2013 were identified in PubMed and Embase. We adhered to MOOSE guidelines and included 22 studies (case-control, cross-sectional studies). A pooled estimate of the HPV prevalence with corresponding 95% confidence interval (CI) was calculated based on a random effect model. In a meta-regression analysis we examined the contribution of different factors to heterogeneity. Furthermore, publication bias was evaluated.
The pooled HPV prevalence in ovarian cancer tissue was 15.5%, but wide variation was found (0–66.7%). After stratification by geographical region, publication year, tissue type and method of HPV detection, we found that the prevalence of HPV varied most markedly by geographical area, the prevalence being 45.6% (95% CI, 31.0–60.3) in Asia, 18.5% (95% CI, 8.5–28.6) in Eastern Europe, 1.1% (95% CI, −1.6 to 3.8) in Western Europe and zero in North America. A meta-regression analysis revealed that the difference between geographical regions could not be explained by HPV detection method or type of tissue.
Great geographical variation exists in HPV prevalence in ovarian cancer tissue, which is not explained by different HPV detection methods. The results suggest that HPV is unlikely to play an important role in Western European and American women, but cannot reject a role of HPV in other populations.