Exploring ethnic disparities in hypospadias incidence: A meta-analysis of epidemiological studies

Introduction Hypospadias is a common congenital condition, yet the etiology and risk factors, including ethnic disparities, are not fully understood. While some studies suggest that ethnicity may influence the incidence of hypospadias, this association has been inadequately explored. This meta-analysis seeks to systematically evaluate the relationship between ethnicity and hypospadias incidence across diverse populations. Methods This review includes cohort and cross-sectional studies examining the incidence of hypospadias and its racial and ethnic disparities. Eligible studies objectively measured hypospadias incidence and included subgroup analyses by ethnicity. We excluded case-control studies, case reports, and commentaries. Literature was systematically searched in Cochrane, PubMed, ScienceDirect, and Scopus, supplemented by manual searches and citation tracing. Search terms were tailored to each database. Study selection and data extraction followed PRISMA 2020 guidelines, with bias risk assessed using Cochrane's RoB 2.0, NOS, and JBI tools. Meta-analysis was performed using RevMan 5.4 with heterogeneity tested by I-2 statistics and results presented in forest plots. Result A total of five studies with a total of 10,348,322 data points were gathered. Pooled analysis showed that white/Caucasian ethnicities had a significantly higher incidence of hypospadias (RR 1.66; 95 % CI, 1.51 to 1.83; p < 0.00001; I2 = 84 %) compared to the Non-White group. Conclusion This systematic review contributes to the understanding of ethnic variations in hypospadias incidence, emphasizing the importance of ethnic diversity in pediatric urological epidemiology. Future research should focus on elucidating genetic, environmental and perinatal determinants across diverse populations to improve healthcare outcomes and reduce disparities in congenital anomaly prevalence.