Dataset for the risk of cervical cancer and high grade lesions among vulnerable women: a systematic review and meta-analysis

Cervical cancer is largely preventable, yet causes around 300,000 deaths annually, disproportionately affecting vulnerable women. We aimed to estimate the risk of high-grade cervical lesions and cervical cancer among vulnerable populations in high- and upper-middle-income countries. We conducted a systematic review and meta-analysis of studies published up to February 2024 (from 2004 for HIV) across four databases. We included women with low socioeconomic status, migrants, prisoners, sex workers, women with substance use disorders, mental illness, and living with HIV. The primary outcome was the pooled risk of cervical cancer and high-grade lesions; the secondary outcome was subgroup-specific risk. The analysis focused on the female sex, defined biologically. Sex was determined according to author reporting and not self-reported. In this work, based on 127 studies, we show that vulnerable women face higher risks of cervical cancer (RR 2.78; 95%CI 2.32–3.32) and high-grade lesions (RR 2.5; 95%CI 2.05–3.04), supporting equity-focused prevention strategies.宫颈癌虽可通过有效干预大幅预防，但每年仍造成约30万例死亡，且对弱势女性群体造成不成比例的沉重影响。本研究旨在估算高收入及中上收入国家中，弱势人群罹患高级别宫颈病变与宫颈癌的发病风险。我们对截至2024年2月（HIV相关研究的检索时限可追溯至2004年）、覆盖4个数据库的已发表文献开展了系统综述与荟萃分析。本研究纳入的研究对象包括社会经济地位低下的女性、移民、在押人员、性工作者、存在物质使用障碍的女性、精神疾病患者以及HIV感染者。本研究的主要结局指标为宫颈癌与高级别宫颈病变的合并发病风险，次要结局指标为亚组特异性发病风险。本分析聚焦于生物学定义的女性群体，受试者性别由作者报告确定，而非自我报告。基于127项研究的本研究结果显示，弱势女性罹患宫颈癌（相对风险（Relative Risk，RR）=2.78；95%置信区间（Confidence Interval，CI）：2.32~3.32）与高级别宫颈病变（RR=2.50；95%CI：2.05~3.04）的风险显著更高，该结果可为以公平为导向的宫颈癌预防策略提供支撑。