Multiple Sexual Partners as a Potential Independent Risk Factor for Cervical Cancer: a Meta-analysis of Epidemiological Studies

Abstract

It’s known that having multiple sexual partners is one of the risk factors of human papillomavirus (HPV)infection which is a major cause of cervical cancer. However, it is not clear whether the number of sexual partnersis an independent risk factor for cervical cancer. We identified relevant studies by searching the databases ofMEDLINE, PubMed and ScienceDirect published in English from January 1980 to January 2014. We analyzedthose studies by combining the study-specific odds ratios (ORs) using random-effects models. Forty-one studieswere included in this meta-analysis. We observed that the number of sexual partners was associated with theoccurrence of non-malignant cervical disease (OR=1.82, 95%CI 1.63-2.00) and invasive cervical carcinoma(OR=1.77, 95%CI 1.50-2.05). Subgroup analyses revealed that the association remained significant aftercontrolling for HPV infection (OR=1.52, 95%CI 1.21-1.83 for non-malignant disease; OR=1.53, 95%CI 1.30-1.76 for invasive cervical carcinoma). We found that there was a non-linear relation of the number of sexualpartners with both non-malignant cervical disease and invasive cervical carcinoma. The risk of both malignantand non-malignant disease is relatively stable in women with more than 4-7 sexual partners. Furthermore, thefrequency-risk of disease remained significant after controlling for HPV infection.The study suggested thath aving multiple sexual partners, with or without HPV infection, is a potential risk factor of cervical cancer.