title: Association between dioxin and cancer incidence and mortality: a meta-analysis.
abstract: The objective of the present study was to systematically assess the association between dioxin/2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and cancer incidence and mortality. Systematic literature searches were conducted until July 2015 in Pubmed, Embase and Cochrane library to identify relevant studies. A random-effects model was applied to estimate the pooled odds ratio (OR), risk ratio (RR), standard incidence ratio (SIR) or standard mortality ratio (SMR) for cancer incidence or mortality. In addition, dose-response, meta-regression, subgroup, and publication bias analyses were conducted. Thirty-one studies involving 29,605 cancer cases and 3,478,748 participants were included. Higher external exposure level of TCDD was significantly associated with all cancer mortality (pooled SMR = 1.09, 95% CI: 1.01-1.19, p = 0.04), but not all cancer incidence (pooled RR = 1.01, 95% CI: 0.97-1.06, p = 0.49). Higher blood level of TCDD was both significantly associated with all cancer incidence (pooled RR = 1.57, 95% CI: 1.21-2.04, p = 0.001) and all cancer mortality (pooled SMR = 1.45, 95% CI: 1.25-1.69, p < 0.001). Subgroup analysis suggested that higher external exposure and blood level of TCDD were both significantly associated with the mortality caused by non-Hodgkin's lymphoma. In conclusion, external exposure and blood level of TCDD were both significantly associated with all cancer mortality, especially for non-Hodgkin's lymphoma.
authors.affiliation: Department of Toxicology, Zhejiang University School of Public Health, Hangzhou, 310058, China.
authors.forename: Jinming
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Toxicology, Zhejiang University School of Public Health, Hangzhou, 310058, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Ye
authors.affiliation: Department of Toxicology, Zhejiang University School of Public Health, Hangzhou, 310058, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Huang
authors.affiliation: Department of Toxicology, Zhejiang University School of Public Health, Hangzhou, 310058, China.
authors.forename: Hanwen
authors.initials: H
authors.lastname: Chen
authors.affiliation: Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China.
authors.forename: Han
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Oncology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Thoracic Surgery, The first Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Toxicology, Zhejiang University School of Public Health, Hangzhou, 310058, China.
authors.forename: Dajing
authors.initials: D
authors.lastname: Xia
authors.affiliation: Department of Toxicology, Zhejiang University School of Public Health, Hangzhou, 310058, China.
authors.forename: Yihua
authors.initials: Y
authors.lastname: Wu
mesh_terms: D002681:China / Q000453:epidemiology; D004147:Dioxins / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology* / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D004147:Dioxins