Incidence of Luminal Gastrointestinal Cancers in Patients with Cirrhosis: A Systematic Review and Meta-analysis

Abstract

Abstract Background: The global incidence of cirrhosis and luminal gastrointestinal cancers are increasing. It is unknown if cirrhosis itself is a predisposing factor for luminal gastrointestinal cancer. Aims: The aim of our study was to investigate the incidence of luminal gastrointestinal cancers in patients with underlying cirrhosis. Methods: An electronic search was conducted to study the incidence of luminal gastrointestinal cancers in patients with cirrhosis. Study-specific standardized incidence ratios (SIR) along with corresponding 95% confidence intervals for both overall cancer incidence and luminal cancer incidence were analyzed using a random-effects model. Subgroup analysis was performed based on cirrhosis etiology and location of luminal malignancy. Results: We identified 5054 articles; 4 studies were selected for data extraction. The overall incidence of all cancers was significantly higher in patients with cirrhosis, with an SIR of 2.79 (95% CI 2.18–3.57). When stratified by cirrhosis etiology, the incidence of luminal cancers remained significantly elevated for alcohol (SIR 3.13, 95% CI 2.24–4.39), PBC (SIR 1.40, 95% CI 1.10–1.79), and unspecified cirrhosis (SIR 3.52, 95% CI 1.87–6.65). Conclusion: The incidence of luminal gastrointestinal cancer is increased amongst patients with cirrhosis. Therefore, increased screening of luminal cancers, and in particular these upper luminal tract subtypes, should be considered in this population.