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Meta-Analysis
. 2021 May 20;11(1):10646.
doi: 10.1038/s41598-021-90175-w.

Primary sclerosing cholangitis and the risk of cancer, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis of cohort studies

Dagfinn Aune  1   2   3   4 , Abhijit Sen  5   6 , Teresa Norat  7 , Elio Riboli  7 , Trine Folseraas  8   9   10
Affiliations
Meta-Analysis

Primary sclerosing cholangitis and the risk of cancer, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis of cohort studies

Dagfinn Aune et al. Sci Rep. .

Abstract

A diagnosis of primary sclerosing cholangitis (PSC) has been associated with increased risk of hepatobiliary cancers, colorectal cancer and all-cause mortality in several studies, while associations with cardiovascular disease have been inconsistent. We conducted a systematic review and meta-analysis of published cohort studies on the topic to summarize these associations. PubMed and Embase databases were searched up to January 13th, 2020. Cohort studies on PSC and risk of cancer, cardiovascular disease, or mortality were included. Summary relative risks (RRs) and 95% confidence intervals (95% CIs) were estimated using random effects models. The summary RR (95% CI) comparing persons with PSC to persons without PSC was 584.37 (269.42-1267.51, I2 = 89%, n = 4) for cholangiocarcinoma (CCA), 155.54 (125.34-193.02, I2 = 0%, n = 3) for hepatobiliary cancer, 30.22 (11.99-76.17, I2 = 0%, n = 2) for liver cancer, 16.92 (8.73-32.78, I2 = 88%, n = 4) for gastrointestinal cancer, 7.56 (2.42-23.62, I2 = 0%, n = 3) for pancreatic cancer, 6.10 (4.19-8.87, I2 = 14%, n = 7) for colorectal cancer (CRC), 4.13 (2.99-5.71, I2 = 80%, n = 5) for total cancer, 3.55 (2.94-4.28, I2 = 46%, n = 5) for all-cause mortality, and 1.57 (0.25-9.69, I2 = 79%, n = 2) for cardiovascular disease. Strong positive associations were observed between PSC and risk of CCA, hepatobiliary cancer, liver cancer, gastrointestinal cancer, pancreatic cancer, CRC, total cancer, and all-cause mortality, but not for cardiovascular disease.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow-chart of study selection.
Figure 2
Figure 2
Primary sclerosing cholangitis and cancer, cardiovascular disease and all-cause mortality. Summary relative risks for each outcome are represented by the squares and the 95% confidence intervals are represented by the lines through the squares (n = number of studies).
Figure 3
Figure 3
Primary sclerosing cholangitis and cholangiocarcinoma, hepatobiliary cancer, liver cancer and gastrointestinal cancer overall.
Figure 4
Figure 4
Primary sclerosing cholangitis and pancreatic cancer, colorectal cancer, total cancer and all-cause mortality.
Figure 5
Figure 5
Primary sclerosing cholangitis and cardiovascular disease.
See this image and copyright information in PMC

References

    1. Hirschfield GM, Karlsen TH, Lindor KD, Adams DH. Primary sclerosing cholangitis. Lancet. 2013;382:1587–1599. doi: 10.1016/S0140-6736(13)60096-3. - DOI - PubMed
    1. Card TR, Solaymani-Dodaran M, West J. Incidence and mortality of primary sclerosing cholangitis in the UK: A population-based cohort study. J. Hepatol. 2008;48:939–944. doi: 10.1016/j.jhep.2008.02.017. - DOI - PubMed
    1. Liu JZ, et al. Dense genotyping of immune-related disease regions identifies nine new risk loci for primary sclerosing cholangitis. Nat. Genet. 2013;45:670–675. doi: 10.1038/ng.2616. - DOI - PMC - PubMed
    1. Andersen IM, Tengesdal G, Lie BA, Boberg KM, Karlsen TH, Hov JR. Effects of coffee consumption, smoking, and hormones on risk for primary sclerosing cholangitis. Clin. Gastroenterol. Hepatol. 2014;12:1019–1028. doi: 10.1016/j.cgh.2013.09.024. - DOI - PubMed
    1. Lammert C, et al. Reduced coffee consumption among individuals with primary sclerosing cholangitis but not primary biliary cirrhosis. Clin. Gastroenterol. Hepatol. 2014;12:1562–1568. doi: 10.1016/j.cgh.2013.12.036. - DOI - PMC - PubMed

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