Published online Mar 28, 2015. doi: 10.3748/wjg.v21.i12.3711
Peer-review started: August 17, 2014
First decision: September 27, 2014
Revised: October 7, 2014
Accepted: November 7, 2014
Article in press: November 11, 2014
Published online: March 28, 2015
AIM: To evaluate the effect of dietary cholesterol and serum total cholesterol (TC) on the risk of pancreatic cancer.
METHODS: A literature search was performed up to June 2014 in PubMed, EMBASE, China National Knowledge Infrastructure and China Biology Medical literature database for relevant articles published in English or Chinese. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated with a random-effects model.
RESULTS: We included 14 published articles with 439355 participants for dietary cholesterol, and 6 published articles with 1805697 participants for serum TC. For the highest vs lowest category of dietary cholesterol, the pooled RR (95%CI) of pancreatic cancer was 1.308 (1.097-1.559). After excluding two studies (RR > 3.0), the pooled RR (95%CI) was 1.204 (1.050-1.380). In subgroup analysis stratified by study design, the pooled RRs (95%CIs) were 1.523 (1.226-1.893) for case-control studies and 1.023 (0.871-1.200) for cohort studies. The association of dietary cholesterol with the risk of pancreatic cancer was significant for studies conducted in North America [1.275 (1.058-1.537)] and others [2.495 (1.565-3.977)], but not in Europe [1.149 (0.863-1.531)]. No significant association [1.003 (0.859-1.171)] was found between the risk of pancreatic cancer and serum TC.
CONCLUSION: Dietary cholesterol may be associated with an increased risk of pancreatic cancer in worldwide populations, except for Europeans. The results need to be confirmed further.
Core tip: Many epidemiological studies have explored the association of cholesterol with the risk of pancreatic cancer, but the results of these studies are conflicting. We conducted the current meta-analysis to evaluate the effect of dietary cholesterol and serum total cholesterol on the risk of pancreatic cancer. The results suggested that dietary cholesterol may be associated with an increased risk of pancreatic cancer. However, the finding needs to be confirmed further.