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Cadmium (Cd) exposure might confer cancer risk. Published studies on the association between Cd levels and liver cancer risk have generated conflicting results. We aimed to conduct a meta-analysis to address the controversy. Relevant literature was searched from the popular bio-databases up to Nov 2022. Essential information was extracted and data were pooled to assess the association between Cd levels and liver cancer risk. Subgroup analysis on sample types and geographical locations was conducted. Then, sensitivity analysis and bias diagnosis were performed to test the credibility of the results. Eleven publications comprising 14 independent studies were selected for analysis and the overall pooled data showed that Cd levels were markedly higher in liver cancer patients than those in healthy controls (SMD = 2.00; 95% CI = 1.20–2.81;  P  &lt; 0.05). To get a prices estimation, the subgroup analyses showed that Cd levels in serum (SMD = 2.55; 95% CI = 1.65–3.45;  P  &lt; 0.05) and hair (SMD = 2.08; 95% CI = 0.34–3.81;  P  &lt; 0.05) were significantly higher in liver cancer patients than those in the healthy controls, respectively. In summary, the data showed that Cd levels were markedly higher in liver cancer patients than those in healthy controls, indicating that Cd accumulation might play important role in the neoplastic transformation of liver cells.

Elevated Serum and Hair Levels of Cadmium as a Risk Factor for Liver Carcinoma: A Meta-Analysis