Jogendran M, Zhu K, Jogendran R, Sabrie N, Hussaini T, Yoshida EM, Chahal D. Incidence of luminal gastrointestinal cancers in patients with cirrhosis: A systematic review and meta-analysis. World J Meta-Anal 2025; 13(1): 101187 [DOI: 10.13105/wjma.v13.i1.101187]
Corresponding Author of This Article
Manisha Jogendran, MD, Doctor, Department of Medicine, Queens's University, 76 Stuart Street, Kingston K7L 2V7, ON, Canada. 13mj5@queensu.ca
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Meta-Anal. Mar 18, 2025; 13(1): 101187 Published online Mar 18, 2025. doi: 10.13105/wjma.v13.i1.101187
Incidence of luminal gastrointestinal cancers in patients with cirrhosis: A systematic review and meta-analysis
Manisha Jogendran, Kai Zhu, Rohit Jogendran, Nasruddin Sabrie, Trana Hussaini, Eric M Yoshida, Daljeet Chahal
Manisha Jogendran, Department of Medicine, Queens's University, Kingston K7L 2V7, ON, Canada
Kai Zhu, Department of Medicine, University of British Columbia, Vancouver 317-2194, BC, Canada
Rohit Jogendran, Nasruddin Sabrie, Department of Medicine, University of Toronto, Toronto 1 King's College Cir M5S 3H2, ON, Canada
Trana Hussaini, BC Liver Transplant Program, Vancouver General Hospital, Vancouver V5Z 1M9, BC, Canada
Eric M Yoshida, Daljeet Chahal, Department of Gastroenterology, University of British Columbia, Vancouver V5Z 1M9, BC, Canada
Co-corresponding authors: Manisha Jogendran and Daljeet Chahal.
Author contributions: Jogendran M, Chahal D designed the research study; Jogendran M, Zhu K, Sabrie N, Jogendran R performed the research; Chahal D, Hussaini T, Yoshida EM contributed new reagents and analytic tools; Jogendran M and Zhu K analyzed the data and wrote the manuscript. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All authors have no conflict-of-interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Manisha Jogendran, MD, Doctor, Department of Medicine, Queens's University, 76 Stuart Street, Kingston K7L 2V7, ON, Canada. 13mj5@queensu.ca
Received: September 6, 2024 Revised: October 26, 2024 Accepted: December 12, 2024 Published online: March 18, 2025 Processing time: 188 Days and 15.7 Hours
Abstract
BACKGROUND
The global incidence of cirrhosis and luminal gastrointestinal cancers are increasing. It is unknown if cirrhosis itself is a predisposing factor for luminal gastrointestinal cancer. Such an association would have significant clinical implications, particularly for cancer screening prior to liver transplantation.
AIM
To investigate the incidence of luminal gastrointestinal cancers in patients with underlying cirrhosis.
METHODS
An electronic search was conducted to study the incidence of luminal gastrointestinal cancers in patients with cirrhosis. Study-specific standardized incidence ratios (SIR) along with corresponding 95%CI for both overall cancer incidence and luminal cancer incidence were analyzed using a random-effects model. Subgroup analysis was performed based on cirrhosis etiology and location of luminal malignancy.
RESULTS
We identified 5054 articles; 4 studies were selected for data extraction. The overall incidence of all cancers was significantly higher in patients with cirrhosis, with an SIR of 2.79 (95%CI: 2.18–3.57). When stratified by cirrhosis etiology, the incidence of luminal cancers remained significantly elevated for alcohol (SIR = 3.13, 95%CI: 2.24–4.39), Primary Biliary Cholangitis (SIR = 1.40, 95%CI: 1.10–1.79), and unspecified cirrhosis (SIR = 3.52, 95%CI: 1.87–6.65).
CONCLUSION
The incidence of luminal gastrointestinal cancer is increased amongst patients with cirrhosis. Oral cavity, pharyngeal and esophageal cancer had increased incidence across all cirrhosis etiologies compared to gastric and colorectal cancer. Therefore, increased screening of luminal cancers, and in particular these upper luminal tract subtypes, should be considered in this population.
Core Tip: Very limited data remains studying the association between luminal gastrointestinal cancers and cirrhosis. We showed that overall incidence of gastrointestinal cancers is higher in patients with cirrhosis. Alcohol related cirrhosis had the highest incidence of oral and pharyngeal cancer. Primary biliary cirrhosis did not demonstrate higher incidence of cancer sites.
