Causal effects of education attainment on oral and oropharyngeal cancer: New evidence from a meta-analysis and Mendelian randomization study

Frontiers in Public Health

Public Health

Di Liu¹  Anzhou Tang¹  Gui Chen²  Xiaowen Zhang³  Junyang Xie³ 

[1] Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China;Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China;State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China;State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China;

关键词: meta-analysis;    Mendelian randomization;    oral cavity and pharyngeal cancer;    association;    education attainment;    genome-wide association study;   

DOI  :  10.3389/fpubh.2023.1132035

 received in 2022-12-26, accepted in 2023-03-28,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectivesHigher educational attainment (EA) has proven to be beneficial for preventing and treating various types of cancers. Currently, there is little evidence on the association between EA and prevention of oral cavity and pharyngeal cancer (OCPC).MethodsSeveral databases were searched until October 1, 2022, and a meta-analysis was performed. A Mendelian randomization (MR) study was conducted with EA (i.e., the exposure) data derived from the Social Science Genetic Association Consortium and 6,034 cases of OCPC (i.e., outcome) selected from the Integrative Epidemiology Unit genome-wide association study. Five methods were used to evaluate the causality between EA and OCPC. The leave-one-out sensitivity test, MR-Egger regression, and multivariable MR (MVMR) analysis were applied to evaluate the MR results.ResultsThe meta-analysis included 36 eligible studies. EA was significantly and negatively associated with OCPC risk (odds ratio [OR]: 0.439, 95% confidence interval [CI]: 0.383–0.503, P < 0.001). MR analysis revealed that the risk of OCPC, oropharyngeal cancer, and oral cavity cancer decreased with an increase in education (OR: 0.349, 95% CI: 0.222–0.548, P < 0.001; OR: 0.343, 95% CI: 0.198–0.597; P < 0.001; OR: 0.342, 95% CI: 0.195–0.601, P < 0.001, respectively). Even after correcting for mediators, high EA still significantly reduced the risk of OCPC (OR: 0.361, 95% CI: 0.281–0.463, P < 0.001).ConclusionBoth the meta-analysis and MR results demonstrated that high levels of EA can reduce the risk of OCPC in the general population.

【 授权许可】

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Copyright © 2023 Chen, Xie, Liu, Zhang and Tang.