Metabolic disorders and the risk of head and neck cancer: a protocol for a systematic review and meta-analysis

Gormley, A.; Richards, C.; Spiga, F.; Gray, E.; Hooper, J.; Main, B. G.; Vincent, E. E.; Richmond, R.; Higgins, J. P.; Gormley, M.

Introduction Head and neck cancer squamous cell carcinoma (HNSCC) is the 6th most common cancer internationally. Established risk factors include smoking, alcohol and presence of human papillomavirus (HPV). The incidence rate of new disease continues to rise, despite falls in alcohol consumption and a reduction in smoking, the rising rates are unlikely to be solely attributed to HPV status alone. Obesity and its associated conditions such as type 2 diabetes (T2D) are implicated in the risk and progression of a variety of cancers but there is paucity of evidence regarding its role in HNSCC. Methods and analysis A systematic review of cohort studies, reporting a risk of incident head and neck squamous cell carcinoma will be included. A systematic search strategy has been developed, multiple databases will be searched from January 1966, including Cochrane Library, OVID SP versions of Medline and EMBASE. The primary outcome will be incident HNSCC based on exposures of type 2 diabetes, obesity, dyslipidemia and hypertension as defined by the World Health Organisation (WHO). A combined risk effect across studies will be calculated using meta-analysis, although depending on the heterogeneity in study design, exposure and outcome reporting this may not be possible. Ethics and dissemination No ethical approval is required for this systematic review. The review will be published in a revelant peer-review journal and findings will be presented at scientific meetings in both poster and oral presentation form. Registration details This study has been registered with the international prospective register of systematic reviews (PROSPERO) with study registration number CRD42021250520. This protocol has been developed in accordance with the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) guidance statement.