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

BackgroundTrichomonas 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. ObjectiveWe aimed to investigate the associations between T. vaginalis infection and cervical carcinogenesis. Search StrategyA comprehensive systematic search was conducted in five databases on 21 October 2021. Selection CriteriaStudies assessing the relationship between T. vaginalis infection, HPV co-infections, cervical dysplasia, and cervical cancer were found eligible. Data Collection and AnalysisSummary estimates for pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated with a random-effects model. Statistical heterogeneity was measured with I-2 and Cochran's Q tests. Main ResultsThe 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; I-2 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; I-2 75%) and cervical cancer (OR 5.23, 95% CI 3.03-9.04; I-2 3%). ConclusionsOur results showed an association between T. vaginalis and cervical carcinogenesis in sexually active women.