Hexavalent chromium and stomach cancer: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#chromium #environmental-exposure #environmental-pollutants #stomach-neoplasms

Hexavalent chromium and stomach cancer: a systematic review and meta-analysis

Suh et al., 2019 | Crit Rev Toxicol | Meta Analysis

Citation

Suh Mina, Wikoff Daniele, ... Proctor Deborah. Hexavalent chromium and stomach cancer: a systematic review and meta-analysis. Crit Rev Toxicol. 2019-Feb;49(2):140-159. doi:10.1080/10408444.2019.1578730

Abstract

Hexavalent chromium [Cr(VI)] is known to cause lung cancer in workers of certain industries, but an association with stomach cancer is uncertain and widely debated. Systematic review and meta-analyses were conducted to assess the risk of stomach cancer mortality/morbidity in humans and experimental animals exposed to Cr(VI). In accordance with the protocol (PROSPERO #CRD4201605162), searches in PubMed and Embase®, and reviews of secondary literature bibliographies, were used to identify eligible studies. Critical appraisal of internal validity and qualitative integration were carried out using the National Toxicology Program's Office of Health Assessment and Translation (OHAT) approach; meta-analyses were conducted based on the occupational data (the only data suitable for quantitative assessment). Forty-seven publications (3 animal, 44 occupational, 0 non-occupational) met the eligibility criteria. Stomach cancer was only observed in one high risk of bias animal study, and in the low risk of bias studies no stomach cancer was observed. Thus, confidence in this evidence base is high. Environmental epidemiology studies did not meet eligibility criteria because exposure and outcome were not measured at the individual level. Meta-analyses of human data resulted in overall meta relative risks of 1.08 (95% CI: 0.96-1.21) including all studies and 1.03 (95%CI: 0.84-1.26) excluding studies associated with the highest risk of bias. Because most occupational studies have high risk of bias for confounding and exposure domains, the overall confidence in this evidence base is low to moderate. Combining the streams of evidence per the OHAT approach, Cr(VI) does not pose a stomach cancer hazard in humans.

Key Findings

Combining the streams of evidence per the OHAT approach, Cr(VI) does not pose a stomach cancer hazard in humans.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Chromium
  • Environmental Exposure
  • Environmental Pollutants
  • Stomach Neoplasms

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review
  • Vertical: chromium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09