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Meta-Analysis
. 2025 Apr 29;20(4):e0319283.
doi: 10.1371/journal.pone.0319283. eCollection 2025.

Cadmium exposure and risk of pancreatic cancer: Systematic review and meta-analysis

Yaser Soleimani  1 , Mohammad Nayebi  1 , Sheyda Mahmoudi  1 , Mahdi Daraei  1 , Soroush Khorsand  1 , Mohammad Amin Jahazi  1 , Maryam Yadollahi Farsi  1 , Fatemeh Khalafi  1 , Mahdieh Varseh  2 , Zahra Mousavi Jarrahi  3 , Mahna Soleimani  1 , Kamelia Massoudnia  1 , Saeideh Karamian  1 , Alireza Mosavi Jarrahi  4
Affiliations
Meta-Analysis

Cadmium exposure and risk of pancreatic cancer: Systematic review and meta-analysis

Yaser Soleimani et al. PLoS One. .

Abstract

Background: Pancreatic cancer is one of the most lethal malignancies, characterized by a poor prognosis and limited treatment options. Increasing evidence suggests that environmental factors, including heavy metal exposure, play a role in pancreatic cancer development. Cadmium, a toxic heavy metal classified as a Group 1 carcinogen, has been implicated in cancer progression. However, its association with pancreatic cancer remains uncertain, with conflicting results from epidemiological studies. This systematic review and meta-analysis aim to assess the association between cadmium exposure and the risk of pancreatic cancer.

Methods: A comprehensive literature search was conducted using multiple databases to identify studies that explored the relationship between cadmium exposure and pancreatic cancer risk. Eleven eligible studies were included in the meta-analysis. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated to estimate the overall effect size. Heterogeneity was assessed using I², T², and Cochran's Q-test. Publication bias was evaluated using Egger's and Begg's tests.

Results: The pooled analysis revealed a significant association between cadmium exposure and the risk of pancreatic cancer, with an overall OR of 2.01 (95% CI: 1.30, 2.72), indicating that individuals exposed to cadmium had more than twice the risk of developing pancreatic cancer compared to those with lower or no exposure. Substantial heterogeneity was observed across studies (I² = 98.08%, T² = 1.37, H² = 52.21). Cochran's Q-test also indicated significant heterogeneity (Q(10) = 304.52, p = 0.00). Egger's test (p = 0.5040) and Begg's test (p = 1.0000) showed no evidence of publication bias.

Conclusion: This meta-analysis demonstrates a significant positive association between cadmium exposure and an increased risk of pancreatic cancer. Despite the considerable heterogeneity across studies, the findings suggest that cadmium is a potential environmental risk factor for pancreatic cancer. Further research is required to explore the underlying biological mechanisms and to develop strategies for reducing cadmium exposure, particularly in high-risk populations.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of systematic review and meta-analysis, cadmium exposure and risk of pancreatic cancer.
Fig 2
Fig 2. Forest plot, meta-analysis of cadmium exposure and risk of pancreatic cancer.
Fig 3
Fig 3. Galbraith plot, demonstrating heterogeneity.
Fig 4
Fig 4. Funnel plot, observed and imputed studies.
See this image and copyright information in PMC

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