A systematic review and meta-analysis of toxic elements exposure and risk of prostate cancer

Abstract Background The evidence on exposure to potentially toxic elements (PTEs) and the risk of prostate cancer has been inconsistent and somewhat unclear. Therefore, in this systematic review and meta-analysis, we evaluated the existing literature comprehensively, to assess the relationship betwe...

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Main Authors: Huamei Zhu, Yutao Chen, Hezhen Chen, Yang Ye, Yuan Chi
Format: Article
Language:English
Published: SpringerOpen 2025-07-01
Series:Environmental Sciences Europe
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Online Access:https://doi.org/10.1186/s12302-025-01156-z
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author Huamei Zhu
Yutao Chen
Hezhen Chen
Yang Ye
Yuan Chi
author_facet Huamei Zhu
Yutao Chen
Hezhen Chen
Yang Ye
Yuan Chi
author_sort Huamei Zhu
collection DOAJ
description Abstract Background The evidence on exposure to potentially toxic elements (PTEs) and the risk of prostate cancer has been inconsistent and somewhat unclear. Therefore, in this systematic review and meta-analysis, we evaluated the existing literature comprehensively, to assess the relationship between exposure to PTEs and the risk of prostate cancer. Methods The execution of this review followed the PRISMA guidelines. An extensive search was carried out in Scopus, Web of Science, and PubMed to locate relevant English-language articles published up until February 27, 2025. Random-effects linear mixed models (REML) meta-analysis was applied for all evaluated associations. Leave-one-out sensitivity analyses were conducted in the meta-analysis to evaluate the reliability of the findings. Publication bias was evaluated using Begg’s test, Egger’s test, funnel plots, and the trim-and-fill method. Results A total of 1118 articles were retrieved, resulting in a final set of 41 articles that were incorporated into our review. Most of the studies had a cross-sectional or case–control design and were conducted in the USA of Europe. The meta-analysis, encompassing 14 studies, revealed no significant link between PTEs exposure and prostate cancer risk. Minimal publication bias was detected, and adjustments did not impact results. Subgroup analyses based on publication year, exposure assessment method, and PTE type revealed no significant associations, except for arsenic (OR = 1.04, 95% CI 1.02–1.06) and lead (OR = 1.04, 95% CI 1.02–1.05), both of which were linked to a slight increase in prostate cancer risk. In contrast, selenium was inversely associated with prostate cancer risk (OR = 0.07, 95% CI 0.03–0.12). Study quality analysis yielded varying risk estimates, with studies classified as “excellent” providing the most consistent results. Meta-regression hinted at a slight, non-significant potential trend of higher standard incidence ratios (SIRs) in recent studies. Conclusion Overall, our study suggests that exposure to PTEs through various pathways may be associated with an increased risk of prostate cancer.
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spelling doaj-art-4b8abff2d4b246e9adb1f86ca788c26f2025-08-20T03:45:52ZengSpringerOpenEnvironmental Sciences Europe2190-47152025-07-0137113710.1186/s12302-025-01156-zA systematic review and meta-analysis of toxic elements exposure and risk of prostate cancerHuamei Zhu0Yutao Chen1Hezhen Chen2Yang Ye3Yuan Chi4Department of Emergency, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityDepartment of Rehabilitation, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical UniversityDepartment of Emergency, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityDepartment of Emergency, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityDepartment of Radiology, Shengjing Hospital of China Medical UniversityAbstract Background The evidence on exposure to potentially toxic elements (PTEs) and the risk of prostate cancer has been inconsistent and somewhat unclear. Therefore, in this systematic review and meta-analysis, we evaluated the existing literature comprehensively, to assess the relationship between exposure to PTEs and the risk of prostate cancer. Methods The execution of this review followed the PRISMA guidelines. An extensive search was carried out in Scopus, Web of Science, and PubMed to locate relevant English-language articles published up until February 27, 2025. Random-effects linear mixed models (REML) meta-analysis was applied for all evaluated associations. Leave-one-out sensitivity analyses were conducted in the meta-analysis to evaluate the reliability of the findings. Publication bias was evaluated using Begg’s test, Egger’s test, funnel plots, and the trim-and-fill method. Results A total of 1118 articles were retrieved, resulting in a final set of 41 articles that were incorporated into our review. Most of the studies had a cross-sectional or case–control design and were conducted in the USA of Europe. The meta-analysis, encompassing 14 studies, revealed no significant link between PTEs exposure and prostate cancer risk. Minimal publication bias was detected, and adjustments did not impact results. Subgroup analyses based on publication year, exposure assessment method, and PTE type revealed no significant associations, except for arsenic (OR = 1.04, 95% CI 1.02–1.06) and lead (OR = 1.04, 95% CI 1.02–1.05), both of which were linked to a slight increase in prostate cancer risk. In contrast, selenium was inversely associated with prostate cancer risk (OR = 0.07, 95% CI 0.03–0.12). Study quality analysis yielded varying risk estimates, with studies classified as “excellent” providing the most consistent results. Meta-regression hinted at a slight, non-significant potential trend of higher standard incidence ratios (SIRs) in recent studies. Conclusion Overall, our study suggests that exposure to PTEs through various pathways may be associated with an increased risk of prostate cancer.https://doi.org/10.1186/s12302-025-01156-zProstate cancerPotentially toxic elementsEnvironmental exposureToxicology
spellingShingle Huamei Zhu
Yutao Chen
Hezhen Chen
Yang Ye
Yuan Chi
A systematic review and meta-analysis of toxic elements exposure and risk of prostate cancer
Environmental Sciences Europe
Prostate cancer
Potentially toxic elements
Environmental exposure
Toxicology
title A systematic review and meta-analysis of toxic elements exposure and risk of prostate cancer
title_full A systematic review and meta-analysis of toxic elements exposure and risk of prostate cancer
title_fullStr A systematic review and meta-analysis of toxic elements exposure and risk of prostate cancer
title_full_unstemmed A systematic review and meta-analysis of toxic elements exposure and risk of prostate cancer
title_short A systematic review and meta-analysis of toxic elements exposure and risk of prostate cancer
title_sort systematic review and meta analysis of toxic elements exposure and risk of prostate cancer
topic Prostate cancer
Potentially toxic elements
Environmental exposure
Toxicology
url https://doi.org/10.1186/s12302-025-01156-z
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