title: Oral sex and risk of oral cancer: a meta-analysis of observational studies.
abstract: OBJECTIVE
  Association between oral sex and oral cancer is a highlighted topic all the time; however, many published epidemiological studies remain failed to obtain a consistent conclusion. We performed this meta-analysis to ascertain whether oral sex is a risk factor or a risk marker for oral cancer.
  
  
  METHODS
  The PubMed database was searched up to 30 August 2013 (latest updated on 21 December 2014) for relevant observational studies that tested the association between oral sex and oral cancer risk. After data extraction from eligible studies, the meta-analysis was conducted using the Comprehensive Meta-Analysis software.
  
  
  RESULTS
  Finally we yielded six case-control studies and one cross-sectional study with 5553 individuals. The results based on random-effects model indicated that there was no significant association between oral sex and risk of oral cancer (OR 1.15, 95% CI 0.86 to 1.54; P = 0.33). Sensitivity analysis showed that the result was robust and subgroups analyses also revealed similar results. Publication bias was not detected.
  
  
  CONCLUSIONS
  Current evidence suggests that oral sex is a risk marker rather than an independent risk factor for oral cancer. However, the practitioners should assure they are without sexually transmitted diseases and with good oral health, and at least cleaned carefully and thoroughly before oral sex.
authors.affiliation: Department of Urology, Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Stomatology, Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
authors.forename: Xiao-Bing
authors.initials: XB
authors.lastname: Ni
authors.affiliation: Department of Urology, Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Xu
authors.affiliation: Department of Urology, Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.|Department of Stomatology, Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China.|Center for Evidence-Based and Translational Medicine, Wuhan University, Wuhan, China.
authors.forename: Xing-Huan
authors.initials: XH
authors.lastname: Wang
authors.affiliation: Department of Stomatology, Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Urology, Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.|Department of Stomatology, Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China.|Center for Evidence-Based and Translational Medicine, Wuhan University, Wuhan, China.
authors.forename: Xian-Tao
authors.initials: XT
authors.lastname: Zeng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology / Q000209:etiology*; D064887:Observational Studies as Topic; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Oral sex; meta‐analysis; oral cancer; oropharyngeal cancer; sexual practices