Systematic review and meta-analysis of lung metastases incidence in cervical cancer patients.

Background

Cervical cancer (CC) is a common and aggressive malignancy in women. The lung is its most frequent site of distant metastasis, yet the incidence and risk factors remain underexplored. This study aimed to estimate the incidence of lung metastases (LMs) in CC and characterize their clinical and pathological patterns.

Methods

We systematically searched PubMed/Medline, Scopus, Embase, Web of Science, and Google Scholar up to May 8, 2025, for studies reporting LMs incidence in CC patients. Eligible studies were assessed using the Joanna Briggs Institute (JBI) tool. Data were analyzed with STATA version 17 using a random-effects model. Pooled estimates were reported with 95% confidence intervals (CIs).

Results

The global pooled incidence of LMs in CC was 4.31% (95% CI: 3.25-5.37), with the highest regional rate observed in Africa (7.42%). Neuroendocrine carcinoma (NEC) demonstrated the highest histology-specific LMs incidence at 16.91% (95% CI: 11.06-22.76), markedly exceeding adenocarcinoma and squamous cell carcinoma. LMs risk was substantially elevated in advanced stages, rising to 15.75% (95% CI: 4.92-26.58) in stage IV compared to 3.12% (95% CI: 1.74-4.51) in stage I, with an average post-metastasis survival of 32.56 months (95% CI: 7.57-57.54).

Conclusion

Our results show that the lung is a common site for metastasis in CC, often alongside liver and bone metastases. LMs risk is higher in neuroendocrine carcinoma and advanced stages. These findings can help improve prevention and treatment strategies.