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

Abstract

Background: Trichomonas 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. Objective: We aimed to investigate the associations between T. vaginalis infection and cervical carcinogenesis. Search Strategy: A comprehensive systematic search was conducted in five databases on 21 October 2021. Selection Criteria: Studies assessing the relationship between T. vaginalis infection, HPV co-infections, cervical dysplasia, and cervical cancer were found eligible. Data Collection and Analysis: Summary 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 Results: The 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%). Conclusions: Our results showed an association between T. vaginalis and cervical carcinogenesis in sexually active women.