Increased risk of Toxoplasma gondii infection in cancer patients: A meta-analysis of current evidence based on case-control study.

Toxoplasma gondii (T. gondii) is an intracellular protozoan parasite that often infects warm-blooded animals or causes opportunistic infections if exists a suppressed immunity. This study aims to investigate the seroprevalence of T. gondii and its odds ratio (OR) in patients with cancer in compared with healthy individuals, and to find the possible factors. Related literatures reported the seroprevalence of T. gondii in cancer/tumor patients and controls (health individuals) were retrieved from electronic databases PubMed, EMBASE, Chinese Web of Knowledge and The Cochrane Library from inception until Aug 31 2018. The non-weighted prevalence of T. gondii, pooled estimates of OR and its 95% confidence intervals (CI) were calculated through random-effect model. Between-study heterogeneity was tested with Cochrane Q, and statistic I was to quantify the results. Funnel plot depiction and Egger's linear regression test were combined to evaluate the potential of publication bias. The literature identified a total of 2216 potential studies; the final 18 studies were incorporated, with 6001 cancer/tumor patients and 6067 controls. Our results demonstrated that, the cancer/tumor patients had an elevated seroprevalence of T. gondii (18.43% vs 8.19%), and an increased risk of T. gondii infection (OR = 3.18, 95% CI: 2.65-3.82) when compared with the controls. Subgroup analyses suggested that publication year, study sample size and diagnostic options are closely associated with the seroprevalence of T. gondii. Overall, our study indicates that there is an increased risk of T. gondii infection in cancer/tumor patients, suggesting a precautionary monitoring of T. gondii and related risk factors in patients with cancer/tumor.