Survivin, a member of the inhibitor of apoptosis protein family, encoded by BIRC5, is involved in the regulation of apoptosis and in cell cycle control. Emerging evidences indicate that polymorphism in BIRC5 promoter (rs9904341) is associated with cancer risk, but the results of individually published studies are inconclusive. Thus, an updated meta-analysis was performed. PubMed was searched for all eligible studies. Pooled odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated to assess the association strength. Stratified analysis was performed by cancer type, source of control, genotyping method, and ethnicity. A number of 26 studies, including 6,041 cases and 7,567 controls were analyzed in this meta-analysis. Overall, significantly increased cancer risk was associated with survivin rs9904341 polymorphism when all studies were pooled (CC vs. GG: OR = 1.36, 95 % CI = 1.09-1.69; P heterogeneity < 0.001; CC vs GC/GG: OR = 1.32, 95 % CI = 1.11-1.57; P heterogeneity < 0.001). Stratified analysis by cancer type revealed that the survivin rs9904341 polymorphism may increase the risk of colorectal cancer, renal cell cancer, gastric cancer, and bladder cancer. Further subgroup analysis by ethnicity indicated that there was a statistically increased cancer risk in Asians but not Caucasians. In this updated meta-analysis of 26 studies, we conclude that the survivin rs9904341 polymorphism might contribute to risk of various cancers, especially in Asian populations.
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