Cadmium Exposure and Risk of Pancreatic Cancer: A Systematic Review and Meta-Analysis
Contenuto principale dell'articolo
Keywords
Abstract
Introduction: Pancreatic cancer is a highly lethal malignancy with poor prognosis and limited treatment options. Environmental exposures, particularly to heavy metals such as cadmium, may contribute to its etiology. This systematic review and meta-analysis evaluated the association between cadmium exposure from different sources and pancreatic cancer incidence or mortality. Methods: Following PRISMA guidelines, we searched PubMed, EMBASE, and Scopus. Eighteen studies comprising 20 risk estimates were included. Random-effects meta-analyses were conducted overall and stratified by exposure source, gender, region, study design, and outcome. Dose-response relationships were assessed using meta-regression of cadmium exposure measures. Publication bias was evaluated using funnel plots and Egger’s test.Results: Overall, cadmium exposure was associated with an increased risk of pancreatic cancer [relative risk (RR) = 1.69, 95% confidence interval (CI): 1.28-2.22]. Occupational exposure showed the most consistent association (RR = 1.38, 95% CI: 1.19-1.61), followed by urinary and blood/serum biomarkers. Risk was higher in men than in women, and in case-control than in cohort studies. Dose-response analysis did not reveal a linear trend. There was limited evidence of publication bias overall, though some asymmetry was observed for urinary cadmium studies (P = 0.045). Conclusion: Cadmium exposure was associated with pancreatic cancer risk, particularly in occupational and biomarker-based studies. While findings support a potential causal link, heterogeneity, residual confounding, and limited dose-response data necessitate cautious interpretation.
Riferimenti bibliografici
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29. Duell E, Lujan-Barroso L, Outzen M, et al. Pre-diagnostic erythrocyte cadmium, selenium, and zinc lev-els and pancreatic cancer risk in Europe. Pancreatology. 2018;18(4 Suppl).
30. Djordjevic VR, Wallace DR, Schweitzer A, et al. Environmental cadmium exposure and pancreatic can-cer: Evidence from case-control, animal and in vitro studies. Environ Int. 2019;128:353-361. Doi: 10.1016/j.envint.2019.04.048.
31. García-Esquinas E, Pollan M, Tellez-Plaza M, et al. Cadmium exposure and cancer mortality in a pro-spective cohort: the Strong Heart Study. Environ Health Perspect. 2014;122(4):363-370. Doi: 10.1289/ehp.1306587. Epub 2014 Feb 14. PMID: 24531129; PMCID: PMC3984227.
32. Järup L, Bellander T, Hogstedt C, Spång G. Mortality and cancer incidence in Swedish battery workers exposed to cadmium and nickel. Occup Environ Med. 1998;55(11):755-759. Doi: 10.1136/oem.55.11.755. PMID: 9924452; PMCID: PMC1757526.
33. Nishijo M, Nakagawa H, Suwazono Y, et al. Cancer mortality in residents of the cadmium-polluted Jinzu River Basin in Toyama, Japan. Toxics. 2018 Apr 6;6(2):23. Doi: 10.3390/toxics6020023. PMID: 29642374; PMCID: PMC6027272.
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35. Stolzenberg-Solomon R, Jin D, Huang WY, Brockman J. Prediagnostic whole-blood cadmium and mo-lybdenum associated with pancreatic cancer in an American cohort. Am J Epidemiol. 2025 7;194(5):1275-1284. Doi: 10.1093/aje/kwae165. PMID: 38965764; PMCID: PMC13070527.
36. Sakurai M, Suwazono Y, Nishijo M, et al. The relationship between the urinary cadmium concentration and cause-specific mortality in subjects without severe renal damage: a 35-year follow-up study in a cadmium-polluted area of Japan. Int J Environ Res Public Health. 2021;18(15):7747. Doi: 10.3390/ijerph18157747. PMID: 34360038; PMCID: PMC8345790.
37. Watanabe Y, Nogawa K, Nishijo M, et al. Relationship between cancer mortality and environmental cadmium exposure in the general Japanese population in cadmium non-polluted areas. Int J Hyg Environ Health. 2020;223(1):65-70. Doi: 10.1016/j.ijheh.2019.09.011.
38. Weiderpass E, Vainio H, Kauppinen T, Vasama-Neuvonen K, Partanen T, Pukkala E. Occupational ex-posures and gastrointestinal cancers among Finnish women. J Occup Environ Med. 2003;45(3):305-315. Doi: 10.1097/01.JOM.0000052963.43131.44.
39. Sorahan T, Lister A, Gilthorpe MS, Harrington JM. Mortality of copper cadmium alloy workers with special reference to lung cancer and non-malignant diseases of the respiratory system, 1946-92. Occup Environ Med. 1995;52(12):804-812. Doi: 10.1136/oem.52.12.804. PMID: 8563843; PMCID: PMC1128381.
40. Zhang Y, Cantor KP, Lynch CF, Zhu Y, Zheng T. Occupation and risk of pancreatic cancer: a popula-tion-based case-control study in Iowa. J Occup Environ Med. 2005;47(4):392-398.
41. Fanfani A, Papini S, Bortolotti E, et al. Cadmium in biological samples and site-specific cancer risk and mortality: A systematic review of original articles and meta-analyses. Cancer Epidemiol. 2024;92:102550. Doi: 10.1016/j.canep.2024.102550. Epub 2024 Mar 12. PMID: 38480109.
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44. Chen C, Xun P, Nishijo M, Sekikawa A, He K. Cadmium exposure and risk of pancreatic cancer: a me-ta-analysis of prospective cohort studies and case-control studies among individuals without occupa-tional exposure history. Environ Sci Pollut Res Int. 2015;22[22]:17465-74. Doi: 10.1007/s11356-015-5464-9. Epub 2015 Oct 1. PMID: 26423282; PMCID: PMC4654666.
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Pubblicato
2026-06-24
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Come citare
1.
Seyyedsalehi MS, Ciaccio L, Marra RF, Boffetta P. Cadmium Exposure and Risk of Pancreatic Cancer: A Systematic Review and Meta-Analysis. Med Lav. 2026;117(3):19093. doi:10.23749/mdl.2026.19093
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Review
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Come citare
1.
Seyyedsalehi MS, Ciaccio L, Marra RF, Boffetta P. Cadmium Exposure and Risk of Pancreatic Cancer: A Systematic Review and Meta-Analysis. Med Lav. 2026;117(3):19093. doi:10.23749/mdl.2026.19093
