Association of Bisphenol A exposure on hormone-associated benign and malignant disorders: A systematic review and meta-analysis

INTRODUCTION: Bisphenol A (BPA) and its analogs have garnered considerable public and scientific attention due to their endocrine-disrupting properties in humans. This systematic review aims to address the question of whether exposure to Bisphenol A is associated with the risk of hormone-associated benign and malignant disorders. METHODS: A comprehensive literature search was conducted from inception to February 2024 to identify eligible human case-control studies investigating exposure to BPA and its analogs. The study selection and data extraction processes were performed independently and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All analyses were conducted using Review Manager (RevMan) software, version 5.4. RESULTS: Following the removal of duplicate records, 661 eligible articles were identified, with 44 studies ultimately included in the final analysis. Bisphenol A was the most frequently investigated contaminant, whereas its analogs were only reported in one study. Most studies reported PCOS, breast cancers, benign and malignant endometrial disorders and only one study reported prostate cancer. The result indicate that BPA exposure is associated with PCOS (SMD=1.19; CI95: 0.70-1.67), benign endometrial disorders (SMD=0.94; CI95: 0.15, 1.73), breast cancer (SMD=0.68; CI95: 0.44-0.92). Nevertheless, these associations demonstrate considerable heterogeneity. CONCLUSION: Bisphenol A exposure is associated with the risk endocrine-related benign and malignant disorders, such as PCOS, breast cancer, and benign endometrial disorders. Nevertheless, the interpretation of these findings is limited by substantial heterogeneity, largely attributable to small sample sizes in case and control groups.