Correlation of serum uric acid with cancer: a systematic evaluation and dose-response meta-analysis of 43 cohort studies

Objective: The association between serum uric acid (SUA) and cancer incidence and mortality remains controversial. In addition, increasing attention has been paid to its potential role in cancer prognosis. Therefore, this study aimed to investigate the correlation between SUA and cancer incidence, mortality, and prognosis through a meta-analysis. Methods: A systematic search of PubMed, Embase, Web of Science, and Cochrane Library was conducted from inception to 28 February 2025. Cohort studies reporting odds ratios (ORs), hazard ratios (HRs), or relative risks (RRs) with 95% confidence intervals (CIs) were included to assess the association between SUA and cancer incidence, mortality, and prognosis. Results: A total of 43 cohort studies involving 3 697 941 participants were included. High SUA levels were not significantly associated with cancer incidence (RR: 1.08; 95% CI: 1.00, 1.16). However, a stronger correlation was observed in females at the time of the sex-stratified study (female RR = 1.20, male RR = 1.10). In addition, high SUA was positively associated with prostate cancer incidence but inversely associated with lung cancer incidence. According to 7 studies, high SUA levels were not associated with total cancer mortality (RR: 0.92; 95% CI: 0.58, 1.48). Conversely, 11 studies reported that elevated SUA levels were significantly associated with poorer overall survival (OS) (RR: 1.81; 95% CI: 1.37, 2.37), especially in breast cancer and non-small cell lung cancer. Conclusion: Elevated SUA was not significantly associated with the incidence of cancer in the total subject population. Although SUA was not associated with cancer mortality, it was significantly associated with poorer overall survival.