Abstract

Telomeres are crucial in the maintenance of chromosome integrity and genomic stability. A series of epidemiological studies have examined the association between telomere length and the risk of cancers, but the findings remain conflicting. We performed literature review and meta-analysis to demonstrate the relationship between telomere length and cancer risk. A total of 23,379 cases and 68,792 controls from 51 publications with 62 population studies were included in this meta-analysis to assess the association between overall cancer or cancer-specific risk and telomere length. General association and dose-response relationship were evaluated based on two and three groups, respectively. The estimates of association were evaluated with odds ratios and 95% confidence intervals by the random-effects or fixed-effects model based on heterogeneity test. We observed a non-significant association between short telomeres and overall risk of cancer. Convincing evidence was observed for the association of short telomeres with an increased risk of gastrointestinal tumor and head and neck cancer. Significant dose-response associations were also observed for gastrointestinal tumor and head and neck cancer. Our findings indicate that telomeres may play diverse roles in different cancers, and short telomeres may be risk factors for the tumors of digestive system.

Highlights

  • Telomeres consist of several thousand DNA repeats of TTAGGG in association with a protein complex at the ends of chromosomes in eukaryotic cells

  • Five reports were excluded because they did not provide the numbers of cases and controls grouped by the relative telomere length[62,63,64,65,66]

  • When pooling all eligible studies into the meta-analysis, we found a non-significant association between short telomeres and an increased risk of overall cancer risk (OR = 1.10, 95% CI: 0.98– 1.23, Table 2)

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Summary

Introduction

Telomeres consist of several thousand DNA repeats of TTAGGG in association with a protein complex at the ends of chromosomes in eukaryotic cells. In 2011, two meta-analysis[9,10] pooling more than 20 studies reported that the short telomeres were associated with increased cancer risk. They found strong evidence for bladder, esophageal, gastric, and renal cancers, but the study numbers were limited for each cancer type. We carried out a systematic review and meta-analysis on 56 relevant literatures[11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66] to estimate the overall cancer risk or cancer-specific risk associated with telomere length and to evaluate potential between-study heterogeneity of these studies

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