Research Paper Volume 14, Issue 5 pp 2148—2173

Parkinson’s disease and cancer: a systematic review and meta-analysis on the influence of lifestyle habits, genetic variants, and gender

Joon Yan Selene Lee1, , Jing Han Ng2, , Seyed Ehsan Saffari1,2, , Eng-King Tan1,2, ,

  • 1 Department of Neuroscience and Behavioural Disorders Programme, Duke-NUS Medical School, Singapore
  • 2 Department of Neurology, National Neuroscience Institute, Singapore

Received: November 16, 2021       Accepted: February 15, 2022       Published: March 5, 2022
How to Cite

Copyright: © 2022 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Purpose: The relationship between Parkinson’s disease (PD) and cancer has been debated. Gender and genetic influences on cancer development in PD is unclear.

Methods: Using QUOROM guidelines, we conducted a systematic review and meta-analysis on potential clinical and genetic factors influencing the PD and subsequent cancer relationship. English articles published in PubMed, Web of Science, and SCOPUS from 2010 to 30 August 2020 were considered for suitability.

Results: Of 46 studies identified, fourteen satisfied the inclusion criteria and were further analysed. Unadjusted risk ratios (RR) and 95% confidence intervals were computed to determine the PD and cancer relationship. PD patients have decreased subsequent cancer risks (RR = 0.87, 95% CI = 0.81–0.93), reduced risks of colon, rectal, and colorectal cancer (RR = 0.77, 95% CI = 0.63–0.94), lung cancer (RR = 0.62, 95% CI = 0.48–0.80), and increased brain cancer (R = 1.48, 95% CI = 1.02–2.13) and melanoma risk (R = 1.76, 95% CI = 1.23–2.50). Compared to idiopathic PD, LRRK2-G2019S carriers had increased general cancer risks (RR = 1.26, 95% CI = 1.09–1.46), particularly brain (RR = 2.41, 95% CI = 1.06–5.50), breast (RR = 2.57, 95% CI = 1.19–5.58), colon (RR = 1.83, 95% CI = 1.13–2.99), and haematological cancers (RR = 2.05, 95% CI = 1.07–3.92). Female PD patients have decreased general cancer risks compared to male PD patients in this analysis (RR = 0.83, 95% CI = 0.69–0.98).

Conclusion: PD patients have reduced risks of colon, rectal, colorectal cancer and lung cancers and increased risks of brain cancer and melanoma. LRRK2-G2019S carriers have increased cancer risks, particularly brain, breast, colon and blood cancers. Female gender was associated with reduced risks. The role of ethnicity, comorbidities, and lifestyle habits on PD patients’ subsequent cancer risk should be further investigated.


PD: Parkinson’s Disease; QUOROM: Quality of Reporting of Meta-analyses; CNS: Central nervous system; LRRK2: Leucine-rich repeat kinase 2; LRRK2-G2019S PD: PD patients with LRRK2-G2019S gene mutation; UCH-L1: Ubiquitin carboxyl-terminal hydrolase L1; NS: Novelty-seeking; HA: Harm avoidance; TMN: 2,3,6-trimethyl-1,4-napthoquinone; MAO: Monoamine oxidase; MPTP: 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine; SCFA: Short chain fatty acids; UV: Ultraviolet; RR: Risk ratio; OR: Odds ratio; SIR: Standardised incidence ratio; HR: Hazard ratio; CI: Confidence interval; RoB: Risk of Bias; NOS: Newcastle-Ottawa Scale; AHRQ: Agency for Healthcare and Research Quality.