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Systematic Reviews
Published in: Systematic Reviews 1/2017

Open Access 01-12-2017 | Protocol

Anorexia nervosa and cancer: a protocol for a systematic review and meta-analysis of observational studies

Authors: Ferrán Catalá-López, Brian Hutton, Jane A. Driver, Manuel Ridao, José M. Valderas, Ricard Gènova-Maleras, Jaume Forés-Martos, Adolfo Alonso-Arroyo, Diego Macías Saint-Gerons, Eduard Vieta, Alfonso Valencia, Rafael Tabarés-Seisdedos

Published in: Systematic Reviews | Issue 1/2017

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Abstract

Background

Anorexia nervosa is characterized by a severe restriction of caloric intake, low body weight, fear of gaining weight or of becoming fat, and disturbance of body image. Pathogenesis of the disorder may include genetic predisposition, hormonal changes and a combination of environmental, psychosocial, and cultural factors. Cancer is the second leading cause of death worldwide. At present, no systematic reviews and meta-analyses have evaluated the risk of cancer in people with anorexia nervosa. The objective of this study will be to evaluate the association between anorexia nervosa and the risk of developing or dying from cancer.

Methods/design

This study protocol is part of a systematic collection and assessment of multiple systematic reviews and meta-analyses (umbrella review) evaluating the association of cancer and multiple central nervous system disorders. We designed a specific protocol for a new systematic review and meta-analysis of observational studies of anorexia nervosa with risk of developing or dying from any cancer. Data sources will be PubMed, Embase, Scopus, Web of Science, and manual screening of references. Observational studies (case–control and cohort) in humans that examined the association between anorexia nervosa and risk of developing or dying from cancer will be sought. The primary outcomes will be cancer incidence and cancer mortality in association with anorexia nervosa. Secondary outcomes will be site-specific cancer incidence and mortality, respectively. Screening of abstracts and full texts, and data abstraction will be performed by two team members independently. Conflicts at all levels of screening and abstraction will be resolved through discussion. The quality of studies will be assessed by using the Ottawa-Newcastle scale by two team members independently. Random effects models will be conducted where appropriate. Subgroup and additional analyses will be conducted to explore the potential sources of heterogeneity. The World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) criteria and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used for determining the quality of evidence for cancer outcomes.

Discussion

Findings from this systematic review will inform an ongoing umbrella review on cancer and central nervous system disorders. Our systematic review and meta-analysis of observational studies will establish the extent of the epidemiological evidence underlying the association between anorexia nervosa and cancer.

Systematic review registration

PROSPERO CRD42017067462.
Appendix
Available only for authorised users
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Metadata
Title
Anorexia nervosa and cancer: a protocol for a systematic review and meta-analysis of observational studies
Authors
Ferrán Catalá-López
Brian Hutton
Jane A. Driver
Manuel Ridao
José M. Valderas
Ricard Gènova-Maleras
Jaume Forés-Martos
Adolfo Alonso-Arroyo
Diego Macías Saint-Gerons
Eduard Vieta
Alfonso Valencia
Rafael Tabarés-Seisdedos
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2017
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-017-0540-5

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