Smoking, alcohol and family history of cancer as risk factors for small intestinal neuroendocrine tumors: a systematic review and meta-analysis

Abstract

<p><b>Objectives:</b> Risk factors for small intestinal neuroendocrine tumors (SI-NETs) are not well understood. The aim of this systematic literature review was to identify risk factors for SI-NET and to further assess these by meta-analysis.</p> <p><b>Material and methods:</b> PubMed and abstracts from the ENETS and NANETS were searched for studies published until May 2015. Eligible studies were selected according to the PRISMA statement.</p> <p><b>Results:</b> Seven studies evaluating six individual populations were included (study accrual period 1980–2012) in the meta-analysis, involving 765 (range 17–325) cases and 502,282 (range 52–498,376) controls. All studies were case–control by design. The following risk factors were reported in ≥2 studies: family history of any cancer, family history of colorectal cancer, ever alcohol use and ever smoking. The pooled OR was 1.34 (95% CI: 1.12–1.60; <i>p</i> < .01; <i>I</i>² = 0.0%) for family history of any cancer, 1.43 (95% CI: 1.15–1.79; <i>p</i> < .01; <i>I</i>² = 0.0%) for family history of colorectal cancer, 1.04 (95% CI: 0.63–1.72; <i>p</i> = .87; <i>I</i>² = 65.0%) for ever alcohol use and 1.40 (95% CI: 1.06–1.86; <i>p</i> < .05; <i>I</i>² = 49.3%) for ever smoking.</p> <p><b>Conclusions:</b> Family history of any cancer, family history of colorectal cancer and history of ever smoking were associated with an increased risk of SI-NET by meta-analysis. Alcohol consumption was not a significant risk factor for SI-NET. However, the studies reporting smoking and alcohol had a high degree of heterogeneity. Therefore, further studies are needed for clarification of smoking and alcohol as risk factors for the occurrence of SI-NET.</p