Biological Trace Element Research

, Volume 179, Issue 2, pp 195–202 | Cite as

Serum Selenium Levels and Cervical Cancer: Systematic Review and Meta-Analysis

  • Du He
  • Zaiping Wang
  • Chuying Huang
  • Xiping Fang
  • Dian ChenEmail author


Several studies have investigated the relationship between serum Se concentration and cervical cancer, but the results were inconsistent. Thus, we conducted a systematic review and meta-analysis to evaluate the association between serum selenium levels and cervical cancer. Twelve studies investigating the association by univariate analysis and five studies by multivariate analysis were identified after a systematic search of PubMed, Wanfang, CNKI, and SinoMed databases. Standard mean differences (SMD) or odds ratios (OR) with the corresponding 95% confidence intervals (CI) were pooled to compare the selenium levels between different groups. In univariate analysis, serum selenium levels in cervical cancer cases were significantly lower than in controls (SMD = −4.86, 95% CI −6.03–3.69). Subgroup analysis showed consistent results. In multivariate analysis, serum selenium levels in cervical cancer cases were also significantly lower than in controls (OR = 0.55, 95% CI 0.42–0.73). After treatment, the serum selenium levels increased significantly (SMD = 2.59, 95% CI 0.50–4.69). In conclusion, high serum selenium levels were associated with cervical cancer, and selenium exposure might be a protective factor for cervical cancer.


Selenium Serum Cervical cancer Meta-analysis 


Compliance with Ethical Standards



Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

12011_2017_982_MOESM1_ESM.doc (61 kb)
ESM 1 (DOC 60 kb)


  1. 1.
    Torre LA, Siegel RL, Ward EM, Jemal A (2016) Global cancer incidence and mortality rates and trends—an update. Cancer Epidemiol Biomark Prev 25(1):16–27. doi: 10.1158/1055-9965.EPI-15-0578 CrossRefGoogle Scholar
  2. 2.
    Hammer A, Rositch A, Qeadan F, Gravitt PE, Blaakaer J (2016) Age-specific prevalence of HPV16/18 genotypes in cervical cancer: a systematic review and meta-analysis. Int J Cancer 138(12):2795–2803. doi: 10.1002/ijc.29959 CrossRefPubMedGoogle Scholar
  3. 3.
    Zhang X, Zhang L, Tian C, Yang L, Wang Z (2014) Genetic variants and risk of cervical cancer: epidemiological evidence, meta-analysis and research review. BJOG 121(6):664–674. doi: 10.1111/1471-0528.12638 CrossRefPubMedGoogle Scholar
  4. 4.
    Zhang X, Dai B, Zhang B, Wang Z (2012) Vitamin a and risk of cervical cancer: a meta-analysis. Gynecol Oncol 124(2):366–373. doi: 10.1016/j.ygyno.2011.10.012 CrossRefPubMedGoogle Scholar
  5. 5.
    Cai X, Wang C, Yu W, Fan W, Wang S, Shen N, Wu P, Li X, Wang F (2016) Selenium exposure and cancer risk: an updated meta-analysis and meta-regression. Sci Rep 6:19213. doi: 10.1038/srep19213 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, Tugwell P (2011) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available at:
  7. 7.
    Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analysis. BMJ 327(7414):557–560. doi: 10.1136/bmj.327.7414.557 CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Duval S, Tweedie R (2000) A nonparametric “trim and fill” method of accounting for publication bias in meta-analysis. J Am Stat Assoc 95(449):89–98. doi: 10.2307/2669529 Google Scholar
  9. 9.
    Sundström H, Ylikorkala O, Kauppila A (1986) Serum selenium and thromboxane in patients with gynaecological cancer. Carcinogenesis 7(7):1051–1052 Available at: CrossRefPubMedGoogle Scholar
  10. 10.
    Lou HK, Wu XR, Fu YQ, Wu ZP, He DQ (1995) Relation between selenium and cancer of uterine cervix. Chinese Journal of Oncology 17(2):112–114 Available at: PubMedGoogle Scholar
  11. 11.
    Zhang H, Wang EZ, Gao YM, Shi F (1996) The concentrations of serum zinc, copper, manganese and selenium in the patients of cervical cancer in Gansu Province. Journal of Lanzhou University (Natural Sciences) 32(2):95–98 Available at: Google Scholar
  12. 12.
    Jing JX, Han CZ, Zheng SM, Zhao XW, Guo JG, Liu FY, Cai JW (2000) Study on correlation of serum, tumor tissue selenium and SIL-2R, TNF-α. Chin J Clin Oncol 27(8):565–567 Available at: Google Scholar
  13. 13.
    Ai ZH, Cheng LK, Zhang HL, Liu HT (2001) Analysis of selenium content in serum of cervix carcinoma patient. Heilongjiang Medical Journal 25(8):572–573 Available at: Google Scholar
  14. 14.
    Zheng SM, Zhang CL, Li LQ, Han CZ, Jing JX, Zhu QY (2004) The relationship of cervical cancer with pathogen infectious, cytokine and Se. Chin J Exp Clin Virol 16(2):179–183 Available at: Google Scholar
  15. 15.
    Cunzhi H, Jiexian J, Xianwen Z, Jingang G, Shumin Z, Lili D (2003) Serum and tissue levels of six trace elements and copper/zinc ratio in patients with cervical cancer and uterine myoma. Biol Trace Elem Res 94(2):113–122. doi: 10.1385/BTER:94:2:113 CrossRefPubMedGoogle Scholar
  16. 16.
    Zhou SL, Yu RZ (2005) The changes of trace elements in the serum of cervical cancer patients before and after operation. Sichuan Journal of Cancer Control 18(1):21–23 Available at: Google Scholar
  17. 17.
    Subramanyam D, Subbaiah KV, Rajendra W, Lokanatha V (2013) Serum selenium concentration and antioxidant activity in cervical cancer patients before and after treatment. Exp Oncol 35(2):97–100 Available at: PubMedGoogle Scholar
  18. 18.
    Xu YX, Yuan L, Chen J, Qin YY (2013) Multivariate analysis in young cervical cancer-the role of trace elements, nutrients and other factors. Chinese Journal of Practical Medicine 29(16):2683–2685 Available at: Google Scholar
  19. 19.
    Wen CH, Feng XQ, Luo RC (2013) Logistic regression analysis on prevalence rate of cervical cancer and risk factors in outpatient. Chinese Journal of Maternal and Child Health Care 28(3):420–422 Available at: Google Scholar
  20. 20.
    Zhang YY, Lu L, Zhang L, Guzalinuer A (2015) The relationship between serum trace element levels and cervical diseases in Uighur females of southern Xinjiang. Acta Universitatis Medicinalis Nanjing (Natural Science) 35(4):557–560 Available at: Google Scholar
  21. 21.
    Yu XY, Wang LH (2016) The factors associated with serum trace element levels and the incidence of cervical diseases/cancer in Qinghai females. Chin J Gerontol 36(15):3774–3775 Available at: Google Scholar
  22. 22.
    Roman M, Jitaru P, Barbante C (2014) Selenium biochemistry and its role for human health. Metallomics 6(1):25–54. doi: 10.1039/c3mt00185g CrossRefPubMedGoogle Scholar
  23. 23.
    Mistry B, Patel RV, Keum YS, Kim DH (2017) Synthesis of N-Mannich bases of berberine linking piperazine moieties revealing anticancer and antioxidant effects. Saudi J Biol Sci 24(1):36–44. doi: 10.1016/j.sjbs.2015.09.005 CrossRefPubMedGoogle Scholar
  24. 24.
    Yao HD, Wu Q, Zhang ZW, Li S, Wang XL, Lei XG, Xu SW (2013a) Selenoprotein W serves as an antioxidant in chicken myoblasts. Biochim Biophys Acta 1830(4):3112–3120. doi: 10.1016/j.bbagen.2013.01.007 CrossRefPubMedGoogle Scholar
  25. 25.
    Yao HD, Wu Q, Zhang ZW, Zhang JL, Li S, Huang JQ, Ren FZ, Xu SW, Wang XL, Lei XG (2013b) Gene expression of endoplasmic reticulum resident selenoproteins correlates with apoptosis in various muscles of Se-deficient chicks. J Nutr 143(5):613–619. doi: 10.3945/jn.112.172395 CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    El-Ghazaly MA, Fadel N, Rashed E, El-Batal A, Kenawy SA (2017) Anti-inflammatory effect of selenium nanoparticles on the inflammation induced in irradiated rats. Can J Physiol Pharmacol 95(2):101–110. doi: 10.1139/cjpp-2016-0183 CrossRefPubMedGoogle Scholar
  27. 27.
    Rayman MP (2012) Selenium and human health. Lancet 379(9822):1256–1268. doi: 10.1016/S0140-6736(11)61452-9 CrossRefPubMedGoogle Scholar
  28. 28.
    Babaknejad N, Sayehmiri F, Sayehmiri K, Rahimifar P, Bahrami S, Delpesheh A, Hemati F, Alizadeh S (2014) The relationship between selenium levels and breast cancer: a systematic review and meta-analysis. Biol Trace Elem Res 159(1–3):1–7. doi: 10.1007/s12011-014-9998-3 CrossRefPubMedGoogle Scholar
  29. 29.
    Gong HY, He JG, Li BS (2016) Meta-analysis of the association between selenium and gastric cancer risk. Oncotarget 7(13):15600–15605. doi: 10.18632/oncotarget.7205 CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Zhang Z, Bi M, Liu Q, Yang J, Xu S (2016) Meta-analysis of the correlation between selenium and incidence of hepatocellular carcinoma. Oncotarget 7(47):77110–77116. doi: 10.18632/oncotarget.12804 PubMedPubMedCentralGoogle Scholar
  31. 31.
    Gong J, Hsu L, Harrison T, King IB, Stürup S, Song X, Duggan D, Liu Y, Hutter C, Chanock SJ, Eaton CB, Marshall JR, Peters U (2013) Genome-wide association study of serum selenium concentrations. Nutrients 5(5):1706–1718. doi: 10.3390/nu5051706 CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Rayman MP (2000) The importance of selenium to human health. Lancet 356(9225):233–241. doi: 10.1016/S0140-6736(00)02490-9 CrossRefPubMedGoogle Scholar
  33. 33.
    Hurwitz BE, Klaus JR, Llabre MM, Gonzalez A, Lawrence PJ, Maher KJ, Greeson JM, Baum MK, Shor-Posner G, Skyler JS, Schneiderman N (2007) Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation: a randomized controlled trial. Arch Intern Med 167(2):148–154. doi: 10.1001/archinte.167.2.148 CrossRefPubMedGoogle Scholar
  34. 34.
    Broome CS, McArdle F, Kyle JA, Andrews F, Lowe NM, Hart CA, Arthur JR, Jackson MJ (2004) An increase in selenium intake improves immune function and poliovirus handling in adults with marginal selenium status. Am J Clin Nutr 80(1):154–162 Available at: PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Du He
    • 1
    • 2
  • Zaiping Wang
    • 1
    • 2
  • Chuying Huang
    • 1
    • 2
  • Xiping Fang
    • 1
    • 2
  • Dian Chen
    • 1
    • 2
    Email author
  1. 1.Department of Oncology, The Central Hospital of Enshi Autonomous of PrefectureEnshi Clinical College of Wuhan UniversityEnshiChina
  2. 2.Enshi Clinical College of Wuhan UniversityEnshiChina

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