Meta-analysis: hyperuricemia, gout tied to higher cancer incidence, mortality

  • Xie Y & al.
  • J Cell Physiol
  • 28 Jan 2019

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • A meta-analysis finds that hyperuricemia and gout are associated with increased cancer incidence and mortality.
  • Digestive, urinary, hematologic cancers are implicated, but the mechanism is unknown.

Why this matters

  • Treatment of hyperuricemia/gout has the potential to reduce cancer risk.

Study design

  • Meta-analysis of 32 prospective and 1 retrospective cohort (N≥2,000,000) after search of PubMed, EMBASE, and Web of Science.
  • Funding: National Natural Science Foundation of China.

Key results

  • Hyperuricemia cancer incidence:
    • Any cancer: pooled relative risk (RR), 1.08; 95% CI, 1.04-1.12.
    • Urinary: pooled RR, 1.28; 95% CI, 1.09-1.50.
    • Digestive: pooled RR, 1.20; 95% CI, 1.08-1.33.
  • Hyperuricemia cancer mortality:
    • Any cancer (pooled RR, 1.15; 95% CI, 1.05-1.26), but effect restricted to males (pooled RR, 1.26; 95% CI, 1.09-1.45).
    • Digestive is nearly significant (pooled RR, 1.25; 95% CI, 0.99-1.53).
  • Gout cancer incidence:
    • Any cancer: pooled RR, 1.19; 95% CI, 1.12-1.25).
    • Urinary: pooled RR, 1.28; 95% CI, 1.11-1.48.
    • Lymphatic/hematologic: pooled RR, 1.29; 95% CI, 1.01-1.66.
    • Digestive: pooled RR, 1.15; 95% CI, 1.07-1.24.
    • Respiratory: pooled RR, 1.11; 95% CI, 1.01-1.21.
  • Gout cancer mortality not reported.
  • Linear relationships between serum uric acid levels and overall cancer incidence (Pnonlinearity=.238) and mortality (Pnonlinearity=.263), suggesting potential dose-response relationships, but authors advise caution.

Limitations

  • Observational designs preclude causal inferences.