title: Prevalence of Human Papillomavirus in endometrial cancer: a systematic review and meta-analysis.
abstract: OBJECTIVE
  HPV is a common sexually transmitted infection and is considered to be a necessary cause of cervical cancer. The anatomical proximity to the cervix has led researchers to investigate whether Human Papillomavirus (HPV) has a role in the etiology of endometrial cancer.
  
  
  METHODS
  We conducted a systematic review and meta-analysis to investigate the pooled prevalence of HPV DNA in endometrial cancer. Using meta-regression, we further analyzed whether factors such as geographical region, HPV DNA detection method, publication year and tissue type were associated with HPV prevalence. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for studies providing data on HPV prevalence in cases with endometrial cancer and in controls with normal or hyperplastic endometrial tissue.
  
  
  RESULTS
  We identified 28 papers (29 studies) examining the prevalence of HPV DNA in tumor tissue from endometrial cancer comprising altogether 1026 cases of endometrial cancer. The HPV prevalence varied considerably from 0% to 61.1%. From the random effects meta-analysis, the pooled prevalence of HPV DNA in endometrial cancer was 10.0% (95% CI: 5.2-16.2) with large between-study heterogeneity (I(2)=88.2%, p<0.0001). The meta-regression showed that HPV DNA detection method was statistically significantly associated with HPV prevalence (p=0.0016): the pooled HPV prevalence was 6.0% (95% CI: 1.5-13.0) using general primers, 18.9% (95% CI: 8.6-32.1) using type-specific primers and 1.0% (95% CI: 0.0-3.6) using non-PCR based methods. None of the other a priori defined variables were statistically significantly associated with HPV prevalence. The pooled OR was 1.43 (95% CI: 0.68-3.00) indicating that the odds of HPV was not increased in cases versus controls.
  
  
  CONCLUSIONS
  HPV appears to have a limited or no role in the etiology of endometrial cancer.
authors.affiliation: Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen O., Denmark.
authors.forename: Tina Bech
authors.initials: TB
authors.lastname: Olesen
authors.affiliation: Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen O., Denmark.
authors.forename: Malene Frøsig
authors.initials: MF
authors.lastname: Svahn
authors.affiliation: Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen O., Denmark.
authors.forename: Mette Tuxen
authors.initials: MT
authors.lastname: Faber
authors.affiliation: Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen O., Denmark.
authors.forename: Anne Katrine
authors.initials: AK
authors.lastname: Duun-Henriksen
authors.affiliation: Department of Pathology, Hvidovre Hospital, Kettegård Allé 30, DK-2650 Hvidovre, Denmark.
authors.forename: Jette
authors.initials: J
authors.lastname: Junge
authors.affiliation: Department of Cellular and Molecular Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
authors.forename: Bodil
authors.initials: B
authors.lastname: Norrild
authors.affiliation: Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen O., Denmark; Gynecologic Clinic, Juliane Marie Centre, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen O., Denmark. Electronic address: susanne@cancer.dk.
authors.forename: Susanne K
authors.initials: SK
authors.lastname: Kjaer
mesh_terms: D004279:DNA, Viral / Q000302:isolation & purification; D016889:Endometrial Neoplasms / Q000821:virology*; D005260:Female; D006801:Humans; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications* / Q000821:virology
chemical_list: D004279:DNA, Viral
keywords: Endometrial cancer; Human Papillomavirus; Meta-analysis; Prevalence; Systematic review