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Submitted: 05 Oct 2024
Revision: 01 Apr 2025
Accepted: 15 Apr 2025
ePublished: 07 Jun 2025
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Immunopathol Persa. Inpress.
doi: 10.34172/ipp.2025.43764
  Abstract View: 14

Meta-analysis

Association between pelvic inflammatory disease and risk of ovarian carcinoma; a systematic review and meta-analysis of observational studies

Elham Saffarieh 1 ORCID logo, Fahimeh Nokhostin 2 ORCID logo, Azadeh Yousefnezhad 3* ORCID logo, Seyedeh Reyhaneh Yousefi Sharami 4* ORCID logo

1 Abnormal Uterine Bleeding Research Center, Semnan University of Medical Sciences, Semnan, Iran
2 Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Sadughi University of Medical Sciences, Yazd, Iran
3 Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran
4 Cancer and Immunology Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
*Corresponding Authors: Azadeh Yousefnezhad, Email: yousefnezhad59@gmail.com; Seyedeh Reyhaneh Yousefi Sharami, Email: Yousefi805@yahoo.com

Abstract

Introduction: Ovarian carcinoma is among the leading causes of cancer deaths due to its asymptomatic growth. Hence, identifying factors affecting ovarian carcinoma incidence is of great significance. Accordingly, the present study examined the association between pelvic inflammatory disease (PID) and ovarian carcinoma.

Materials and Methods: The PRISMA checklist was used to design the current systematic review and meta-analysis. Databases, including ProQuest, PubMed, Web of Science, Cochrane, and Google Scholar Search Engine, were used without a time limit until September 8, 2024. Data was analyzed using the STATA 14 software, and tests with P values lower than 0.05 (P < 0.05) were considered statistically significant.

Results: A total of 20 studies (13 cohort and seven case-control) conducted from 1995 to 2024 were combined, and the total number of patients with PID in the studies was 754268. Results revealed that PID increased ovarian carcinoma risk (HR: 1.33, 95% CI: 1.19, 1.48) and number of PID episodes (2) increased the risk of ovarian neoplasm (HR: 1.42, 95% CI: 1.10, 1.83). However, there was no statistically significant relationship between the number of PID episodes (1) (HR: 1.09, 95% CI: 0.98, 1.22) and number of PID episodes (≥3) (HR: 1.39, 95% CI: 0.54, 3.58) and the risk of ovarian carcinoma. PID increased the risk of ovarian carcinoma in age groups 20 to 29 (HR: 1.44, 95% CI: 1.31, 1.59), 30 to 39 (HR: 1.43, 95% CI: 1.04, 1.97), 40 to 49 (HR: 1.37, 95% CI: 1.16, 1.63), and 50 to 59 (HR: 1.39, 95% CI: 1.07, 1.81). Furthermore, PID raised the risk of serous carcinoma (HR: 1.36, 95% CI: 1.09, 1.69). Nevertheless, there was no statistically significant relationship between PID and the risk of endometrioid (HR: 0.87, 95% CI: 0.65, 1.18), mucinous (HR: 1.06, 95% CI: 0.89, 1.26), and clear cell carcinoma (HR: 1.05, 95% CI: 0.66, 1.66).

Conclusion: Pelvic inflammatory disease increases the risk of ovarian carcinoma and serous carcinoma. Taiwanese patients with PID aged 20 to 39 had higher rates of exposure to ovarian carcinoma than other patients.

Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42024590681) and Research Registry (UIN: reviewregistry1885) website.



Citation: Saffarieh E, Nokhostin F, Yousefnezhad A, Yousefi Sharami SR. Association between pelvic inflammatory disease and risk of ovarian carcinoma; a systematic review and meta-analysis of observational studies. Immunopathol Persa. 2025;x(x):e43764. DOI:10.34172/ipp.2025.43764.
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