The Association Between Cadmium Exposure and Endometrial Cancer Risk: Evidence from a Comprehensive Updated Meta-Analysis

TL;DR

This study finds that exposure to cadmium may increase the risk of endometrial cancer, based on a meta-analysis of observational studies.

Contribution

A comprehensive updated meta-analysis linking cadmium exposure to endometrial cancer risk using recent data up to 2025.

Findings

Cadmium exposure was associated with a 27% increased risk of endometrial cancer (OR = 1.27).

Stronger associations were observed in case–control studies and European populations.

The association remained significant in high-quality and adjusted analyses.

Abstract

Background: The carcinogenic potential of cadmium has been suggested, but its association with endometrial cancer risk remains uncertain. This meta-analysis aimed to evaluate whether cadmium exposure is associated with the risk of endometrial cancer. Methods: A thorough search of seven databases was conducted to identify observational studies published up to September 2025. The Newcastle-Ottawa Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) tool were utilized to evaluate the quality of observational studies. The I2 statistic was calculated to assess heterogeneity among studies. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using a random-effects model. Furthermore, sensitivity analysis, subgroup analysis, and an assessment of publication bias were performed. Results: Eight studies involving 196,456 participants were included. Study quality assessment indicated that all included studies were of moderate or high quality. Overall, cadmium exposure was associated with an increased risk of endometrial cancer (OR = 1.27, 95% CI: 1.07–1.50, I2 = 64.1%). Stronger associations were observed in case–control studies, European populations, and studies using blood or urinary cadmium biomarkers. The association remained significant in high-quality and adjusted analyses. Conclusions: The findings of this meta-analysis suggest a possible association between cadmium exposure and endometrial cancer risk. However, given the observational nature of the included studies, causality cannot be established. Further large-scale, well-designed prospective studies with standardized exposure assessment are needed to clarify this relationship.

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