Purpose of Review <p>Nickel (Ni) is a ubiquitous environmental metal classified as a human carcinogen (Group 1). While occupational exposure to Ni compounds has been linked to increased cancer incidence and mortality, particularly in the respiratory tract, the effects of low-dose, prolonged exposure among the general population remain unclear. This systematic review evaluates the current evidence on the association between Ni levels in biological samples and cancer risk.</p> Recent Findings <p>A systematic search of PubMed and EMBASE was conducted from inception until February 3rd, 2025, to identify epidemiological and clinical studies measuring Ni concentrations in biological samples (blood, urine, toenails) and relation to cancer incidence or mortality. Twenty studies published between 2008 and 2024 met the criteria and were included in the review. Most were case–control studies, with only one prospective cohort study. Ni concentrations in blood was generally directly associated with an increased risk of head and neck and liver cancers, while higher urinary Ni levels correlated with a greater risk of urothelial cancer. No significant associations were found for lung, breast, prostate, or colorectal cancers. Single studies were available for paediatric haematological malignancies, pancreatic cancer, and cumulative cancer risk.</p> Summary <p>A potential role of Ni was suggested for the carcinogenesis of the head and neck, liver, and bladder, while findings for other cancer types remain sometimes inconsistent. The limited number of studies, heterogeneity in biological samples, and lack of prospective data highlight the need for further research.</p>

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Nickel in Biological Samples in Association with Cancer Risk: a Systematic Literature Review

  • Alice Graziani,
  • Maddalena Carretti,
  • Giovanna Berti,
  • Guglielmo Bonaccorsi,
  • Chiara Doccioli,
  • Calogero Saieva,
  • Saverio Caini

摘要

Purpose of Review

Nickel (Ni) is a ubiquitous environmental metal classified as a human carcinogen (Group 1). While occupational exposure to Ni compounds has been linked to increased cancer incidence and mortality, particularly in the respiratory tract, the effects of low-dose, prolonged exposure among the general population remain unclear. This systematic review evaluates the current evidence on the association between Ni levels in biological samples and cancer risk.

Recent Findings

A systematic search of PubMed and EMBASE was conducted from inception until February 3rd, 2025, to identify epidemiological and clinical studies measuring Ni concentrations in biological samples (blood, urine, toenails) and relation to cancer incidence or mortality. Twenty studies published between 2008 and 2024 met the criteria and were included in the review. Most were case–control studies, with only one prospective cohort study. Ni concentrations in blood was generally directly associated with an increased risk of head and neck and liver cancers, while higher urinary Ni levels correlated with a greater risk of urothelial cancer. No significant associations were found for lung, breast, prostate, or colorectal cancers. Single studies were available for paediatric haematological malignancies, pancreatic cancer, and cumulative cancer risk.

Summary

A potential role of Ni was suggested for the carcinogenesis of the head and neck, liver, and bladder, while findings for other cancer types remain sometimes inconsistent. The limited number of studies, heterogeneity in biological samples, and lack of prospective data highlight the need for further research.