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Shortened Telomere Length Is Associated with Increased Risk of Cancer: A Meta-Analysis
Open accessAbstract
BACKGROUND: Telomeres play a key role in the maintenance of chromosome integrity and stability, and telomere shortening is involved in initiation and progression of malignancies. A series of epidemiological studies have examined the association between shortened telomeres and risk of cancers, but the findings remain conflicting. METHODS: A dataset composed of 11,255 cases and 13,101 controls from 21 publications was included in a meta-analysis to evaluate the association between overall cancer risk or cancer-specific risk and the relative telomere length. Heterogeneity among studies and their publication bias were further assessed by the χ(2)-based Q statistic test and Egger's test, respectively. RESULTS: The results showed that shorter telomeres were significantly associated with cancer risk (OR = 1.35, 95% CI = 1.14-1.60), compared with longer telomeres. In the stratified analysis by tumor type, the association remained significant in subgroups of bladder cancer (OR = 1.84, 95% CI = 1.38-2.44), lung cancer (OR = 2.39, 95% CI = 1.18-4.88), smoking-related cancers (OR = 2.25, 95% CI = 1.83-2.78), cancers in the digestive system (OR = 1.69, 95% CI = 1.53-1.87) and the urogenital system (OR = 1.73, 95% CI = 1.12-2.67). Furthermore, the results also indicated that the association between the relative telomere length and overall cancer risk was statistically significant in studies of Caucasian subjects, Asian subjects, retrospective designs, hospital-based controls and smaller sample sizes. Funnel plot and Egger's test suggested that there was no publication bias in the current meta-analysis (P = 0.532). CONCLUSIONS: The results of this meta-analysis suggest that the presence of shortened telomeres may be a marker for susceptibility to human cancer, but single larger, well-design prospective studies are warranted to confirm these findings.
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“Inter-individual variation in mean leukocyte telomere length (LTL) is associated with cancer and several age-associated diseases.”
From Identification of seven loci affecting mean telomere length and their association with disease (2013) · cites this paper as [4]
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Leukocyte Telomere Length in Patients with Radiographic Knee Osteoarthritis
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“Moreover, several meta‐analyses suggest that telomere size measured in PBL is useful to assess the individual predisposition to numerous pathologies associated to aging, like several cancers, diabetes and cardiovascular disease (Ma et al., 2011; Zhao et al., 2013; Haycock et al., 2014).”
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Filaggrin variations are associated with PAH metabolites in urine and DNA alterations in blood
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“Not surprisingly, numerous studies have reported a relationship between mean leukocyte TL and cancer incidence and mortality, but for many cancers the results have been inconsistent (20, 21, 37).”
ResultLiljedahl, E. R., Wahlberg, K. E., Lidén, C., Albin, M. C., & Bröberg, K. (2018) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2018.10.328 · Cited by 14
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“…between LTL and all cancers combined [16], breast [17], colorectal [18], prostate [19], and lung cancer risk [20]; however, others have found a positive association between short telomere length with an increased risk in all cancers combined [21], and gastrointestinal, head, and neck cancers [22].”
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Genetics and Epigenetics of Lung Cancer: Mechanisms and Future Perspectives
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“These conflicting results may be due to the fact that chromosomal shortening up to a critical length may result in chromosomal breaks, causing genome instability and thus leading to enhanced potential for malignant transformation in lung cancer, while in the case of breast cancer several other factors such as estrogen…”
BackgroundLack of association between PBMC telomere length and endurance exercise
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“…case-control study failed to observe a statistically significant association between leukocyte TL and PCa risk using quantitative PCR (27), two meta‑analyses revealed that shorter telomeres were significantly associated with an increased overall risk of cancer compared with longer telomeres (28).”
Chmelar, C., Jörres, R. A., Kronseder, A., Müller, A., Nowak, D., & Weigl, M. (2017) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001102 · Cited by 11
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“Telomere detrition has been associated with several degenerative diseases and health outcomes in adults, including type II diabetes [10, 11], cancer [12, 13], dementia [14, 15], cardiovascular disease [16, 17], and psychosocial disorders [18].”
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“This finding has important public health implications as adult TL, which is a function of the initial set point and attrition over time (Aviv, 2008), has been linked to stress-related diseases (Darrow et al., 2016; Haycock et al., 2014; Ma et al., 2011).”
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“Interestingly, two recent meta-analyses indicated that the significant associations between telomere length and cancer risk were observed mostly in retrospective but not the a few prospective studies (23,24).”
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Lifestyle Choices, Psychological Stress and Their Impact on Ageing: The Role of Telomeres
Davinelli, S., & Vivo, I. D. (2019) · Springer eBooks · doi:10.1007/978-3-030-20762-5_8 · Cited by 9
Al‐Daghri, N. M., Sabico, S., Ansari, M. G. A., Abdi, S., Tripathi, G., Chrousos, G. P., & McTernan, P. G. (2022) · Saudi Journal of Biological Sciences · doi:10.1016/j.sjbs.2022.03.026 · Cited by 10
“Epidemiological investigations have shown that associations exist between diminished telomere length (TL) and a number of adverse health outcomes including risk of cardiovascular diseases, type 2 diabetes mellitus (T2DM) and cancer (Hoffmann and Spyridopoulos 2011; Ma et al., 2011).”
BackgroundAndreassi, M. G., Haddy, N., Harms‐Ringdahl, M., Campolo, J., Borghini, A., Chevalier, F., Schwenk, J. M., Fresneau, B. C., Bolle, S., Fuentes, M., et al. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24098416 · Cited by 12
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“Telomeres tend to shorten with increasing age, and with that shortening, there is an increase in vulnerability to agerelated diseases (Ma et al. 2011; Muezzinler et al. 2013; D’Mello et al. 2015).”
BackgroundLeukocyte Telomere Length and Pancreatic Cancer Risk
Antwi, S. O., & Petersen, G. M. (2018) · Pancreas · doi:10.1097/mpa.0000000000000995 · Cited by 10
“Three overlappingmeta-analyses have examined the association between TL and cancer risk.(52,62,63) The first meta-analysis included 11,255 cancer cases and 13,101 controls from 21 studies published up to November 2010(62) and found increased overall cancer risk among individuals with short telomeres (OR, 1.”
Antwi, S. O., Bamlet, W. R., Rabe, K. G., Cawthon, R., Umudi, I., Druliner, B. R., Sicotte, H., Oberg, A. L., Jatoi, A., Boardman, L. A., et al. (2020) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-19-1597 · Cited by 10
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“The above-mentioned studies [65,66] found an increased risk of cancer in persons with shorter telomeres in blood leukocytes and buccal mucosae cells.”
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“Given its significance, TL has been suggested as a potential marker for cancer susceptibility in humans (Heaphy et al., 2022; Ma et al., 2011; Sun et al., 2015).”
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Chang, S., Prescott, J., Vivo, I. D., Kraft, P. L., & Okereke, O. I. (2018) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2018.05.021 · Cited by 10
Differences in telomere length between sporadic and familial cutaneous melanoma
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Pavanello, S., Varesco, L., Gismondi, V., Bruzzi, P., & Bolognesi, C. (2018) · PLoS ONE · doi:10.1371/journal.pone.0197522 · Cited by 10
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“Two large-scale meta-analysis found shorter telomeres to be significantly associated with specific types of cancer (25, 26).”
Predicted leukocyte telomere length and risk of germ cell tumours
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From premature birth to premature kidney disease: does accelerated aging play a role?
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Depressive symptoms and shorter survival in lung cancer: the role of leukocyte telomere length
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“…in the general population (Needham et al., 2015; Rode et al., 2015; Wang et al., 2018) and is associated with increased risk for tumourigenesis (Ma et al., 2011; Shao et al., 2007; Wentzensen et al., 2011; Willeit et al., 2010; Wu et al., 2003), earlier mortality (Wentzensen et al., 2011;…”
BackgroundEpigenetic aging differentially impacts breast cancer risk by self-reported race
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EGCG Containing Combined Dietary Supplement Affects Telomeres and Epigenetic Regulation
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“Further, DNA methylation and telomeres are linked to various diseases such as cardiovascular disorders, T2DM and cancer [55-58].”
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“Shorter telomeres are associated with an increased incidence of disease and poorer survival rates [5].”
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“Categorized as a chronic metabolic disorder, Type 2 diabetes is also the underlying cause of genomic instability secondary to telomere shortening.[30] Using the Southern blot technique to measure terminal restriction fragment, which determines telomere length, shortening of telomere in Type 2 diabetics of Asian-Indian…”
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Adverse pregnancy outcomes are associated with shorter telomere length in the 17-year-old child
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Relationship between interpersonal sensitivity and leukocyte telomere length
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Decoding the tumor-aging axis: from bench to clinical
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Self-citationMaterial hardship and telomere length in children
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“Human population studies show associations between shorter TL in adult-hood and a wide range of diseases and health morbidities, including cancer (Ma et al., 2011), coronary artery disease (Farzaneh-Far et al., 2010; Willeit et al., 2010), type 2 diabetes mellitus (Zhao et al., 2013), dementia…”
Metadata
- Authors
- Ma, H., Zhou, Z., Wei, S., Liu, Z., Pooley, K. A., Dunning, A. M., Svenson, U., Roos, G., Hosgood, H. D., Shen, M., & Wei, Q.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- University of Cambridge (GB)
- Umeå University (SE)
- National Institutes of Health (US)
- Corresponding author
- Wei, Qingyi
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2011-06-10
- Volume
- 6
- Issue
- 6
- Pages
- e20466
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3112149
- OpenAlex
- W2136996519
- Cited by
- 376
- References
- 73
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 21 · 2023: 16 · 2022: 19 · 2021: 24 · 2020: 25 · 2019: 32 · 2018: 34 · 2017: 27 · 2016: 33 · 2015: 34 · 2014: 35 · 2013: 36 · 2012: 18
- FWCI
- 3.27
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DiVA at Umeå University (Umeå University) (submittedVersion, other-oa)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Cancer Institute (R01CA131274, P30CA016672)
- National Institute of Environmental Health Sciences (R01ES011740)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Telomeres, Telomerase, and Senescence
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Epigenetics and DNA Methylation
- Keywords
- telomere length, telomere shortening, cancer risk, cancer susceptibility, bladder cancer, lung cancer, tobacco-related cancer, gastrointestinal cancer, urogenital cancer, biomarkers
- MeSH terms
- Humans, Neoplasms, Risk Factors, Confidence Intervals, Odds Ratio, Telomere, Publication Bias, Genetic Predisposition to Disease
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