The IVW results indicated that cathepsin G was associated with a 36.9% increase in the risk of HCC (OR = 1.369), cathepsin B was linked to a 69.3% increase in the risk of BTC (OR = 1.693), while cathepsin H was found to reduce the risk of PCa by 10.4% (OR = 0.896), and cathepsin L2 was associated with an 18.6% reduction in the risk of CRC (OR = 0.814). Here, CTSH is linked to posterior cortical atrophy.