Association between Epstein-Bar virus and colorectal cancer: A systematic review and meta-analysis

Aim: This study aimed to investigate the prevalence and anypotential association between Epstein-Barr virus (EBV) infectionand colorectal cancer (CRC).Methods: A systematic literature search was performed byfinding relevant cross-sectional and case-control studies frommain online databases. Heterogeneity, odds ratio (OR), and corresponding۹۵% confidence interval (CI) were applied to allstudies through meta-analysis and forest plots. The analysis wasperformed using STATA Software v.۱۴.۱.Results: Twenty-three articles were included in the meta-analysis,eight of them were case/control and ۱۵ were cross-sectional.The pooled prevalence of EBV among ۱۹۵۴ CRC patients was۱۸% (۹۵% CI: ۱۲%–۲۶%; I۲ = ۹۳.۱۴%). Furthermore, in geographicalregions, the highest and lowest prevalence of EBVwas observed in South America ۳۰% (۹۵% CI: ۱۸%–۴۳%) andAfrica ۰% (۹۵% CI: ۰%–۵%), respectively. An association wasfound between EBV infection and CRC [OR = ۳.۴ (۹۵% CI(۱.۱۳–۱۰.۲۷); I۲ = ۷۲.۳%)].Conclusion: EBV infection is associated with CRC and can beconsidered a potential risk factor for the development of CRC.Although the exact molecular mechanism of EBV infection inthe development of CRC is still unknown, it seems that latentinfection by EBV, intestinal damage, and inflammation can beimportant factors in the induction of CRC.