Cited by 376Telomeres, Telomerase, and SenescenceGenetic Associations and EpidemiologyEpigenetics and DNA Methylation

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Shortened Telomere Length Is Associated with Increased Risk of Cancer: A Meta-Analysis

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Abstract

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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Crossref · 10.1371/journal.pone.0020466

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Figure 1 Flow chart for the process of selecting the final 21 publications.
Figure 1 Flow chart for the process of selecting the final 21 publications.CC BY · PubMed Central
Figure 2 Odds ratios (ORs) and 95% confidence intervals (CIs) for overall cancer risk associated with relative telomere length (shorter vs. longer, grouped by the median of telomere length ratio). a Some controls were shared in the study by Wu et al (2003) that included a total of 313 cases and 256 controls.
Figure 2 Odds ratios (ORs) and 95% confidence intervals (CIs) for overall cancer risk associated with relative telomere length (shorter vs. longer, grouped by the median of telomere length ratio). a Some controls were shared in the study by Wu et al (2003) that included a total of 313 cases and 256 controls.CC BY · PubMed Central
Figure 3 Odds ratios (ORs) and 95% confidence intervals (CIs) for risk of different cancers associated with relative telomere length (shorter vs. longer, grouped by median value of telomere length ratio). (A) Smoking-related cancers; (B) Cancers in the digestive system; (C) Cancers in the urogenital system.
Figure 3 Odds ratios (ORs) and 95% confidence intervals (CIs) for risk of different cancers associated with relative telomere length (shorter vs. longer, grouped by median value of telomere length ratio). (A) Smoking-related cancers; (B) Cancers in the digestive system; (C) Cancers in the urogenital system.CC BY · PubMed Central
Figure 4 Funnel plot analysis to detect publication bias. Each point represents an independent study for the indicated association.
Figure 4 Funnel plot analysis to detect publication bias. Each point represents an independent study for the indicated association.CC BY · PubMed Central

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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
Venue
PLoS ONE
Published
2011-06-10
Volume
6
Issue
6
Pages
e20466
ISSN
1932-6203 (ISSN-L)
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
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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