Effect of exposure to ambient air pollution on gynecological cancer: A systematic review

Abstract

Abstract Background The importance of gynecological cancer and air pollution awareness cannot be overemphasized. Various studies undertaken worldwide have found that exposure to atmospheric pollutants can lead to high morbidity and mortality due to gynecological cancer. Hence, it is critical to address this issue for the prevention and reduction of gynecological cancers. Objective This review was conducted to objectively assess the effect of exposure to ambient air pollution on gynecological cancer and its related factors among women. Methods A systematic review and meta-analysis of quantitative research were conducted. We searched 5 electronic databases: CINAHL (EBSCO Academic Search Premier); Google Scholar; Embase; PubMed and Web of Knowledge to identify relevant studies for inclusion from January 2011 to December 2021. The quality of each study included for meta-analysis was determined using the Joanna Briggs Institute Critical appraisal tool. Results 18,324 records were identified from the electronic data search. 16,535 records were filtered systematically. Finally, 12 studies involving 5 population-based cross-sectional studies using secondary data from demographic health surveys conducted prior, 2 cohort studies, 3 articles are case-control studies, 1 ecological study, and 1 meta-analysis were added in the final analysis. Accordingly, the overall point estimate of gynecological (cervical, ovarian, and endometrial) cancer among women worldwide was 50% (95%CI: 43 ~ 57%). High heterogeneity (I2 = 99.72%, p < 0.001) was noticed which could be due to factors not explored in this review. The factors commonly associated with gynecological cancer were occupation, procreation, age, diabetes, the number of births, drinking, a family history of cancer, menstrual cycle, and environmental tobacco smoke (ETS). Conclusion Long-term air pollution exposure has a significant impact on the occurrence and development of gynecological tumors. The interaction between ambient air pollution and sensitive determinants can significantly increase the risk of gynecological tumors. Air pollution exposure may be high in most countries worldwide. Hence, there was heterogeneity in the effect of exposure to ambient air pollution on gynecological cancer.