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Cancer Causes & Control
Published in: Cancer Causes & Control 7/2013

Open Access 01-07-2013 | Original paper

Iron metabolism and risk of cancer in the Swedish AMORIS study

Authors: Anjali Gaur, Helen Collins, Wahyu Wulaningsih, Lars Holmberg, Hans Garmo, Niklas Hammar, Göran Walldius, Ingmar Jungner, Mieke Van Hemelrijck

Published in: Cancer Causes & Control | Issue 7/2013

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Abstract

Objectives

Pre-clinical studies have shown that iron can be carcinogenic, but few population-based studies investigated the association between markers of the iron metabolism and risk of cancer while taking into account inflammation. We assessed the link between serum iron (SI), total-iron binding capacity (TIBC), and risk of cancer by levels of C-reactive protein (CRP) in a large population-based study (n = 220,642).

Methods

From the Swedish Apolipoprotein Mortality Risk (AMORIS) study, we selected all participants (>20 years old) with baseline measurements of serum SI, TIBC, and CRP. Multivariate Cox proportional hazards regression was carried out for standardized and quartile values of SI and TIBC. Similar analyses were performed for specific cancers (pancreatic, colon, liver, respiratory, kidney, prostate, stomach, and breast cancer). To avoid reverse causation, we excluded those with follow-up <3 years.

Results

We found a positive association between standardized TIBC and overall cancer [HR 1.03 (95 % CI 1.01–1.05)]. No statistically significant association was found between SI and cancer risk except for postmenopausal breast cancer [HR for standardized SI 1.09 (95 % CI 1.02–1.15)]. The association between TIBC and specific cancer was only statistically significant for colon cancer [i.e., HR for standardized TIBC: 1.17 (95 % CI 1.08–1.28)]. A borderline interaction between SI and levels of CRP was observed only in stomach cancer.

Conclusions

As opposed to pre-clinical findings for serum iron and cancer, this population-based epidemiological study showed an inverse relation between iron metabolism and cancer risk. Minimal role of inflammatory markers observed warrants further study focusing on developments of specific cancers.
Literature
1.
Mascitelli L, Goldstein MR (2011) Metabolic syndrome and liver cancer: is excess iron the link? Hepatology 54(4):1487PubMedCrossRef
2.
3.
Kabat GC, Miller AB, Jain M, Rohan TE (2007) A cohort study of dietary iron and heme iron intake and risk of colorectal cancer in women. Br J Cancer [Research Support, Non-US Gov’t] 97(1):118–122
4.
Kabat GC, Miller AB, Jain M, Rohan TE (2007) Dietary iron and heme iron intake and risk of breast cancer: a prospective cohort study. Cancer Epidemiol Biomarkers Prev [Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov’t] 16(6):1306–1308CrossRef
5.
Cross AJ, Sinha R, Wood RJ, Xue X, Huang WY, Yeager M et al (2011) Iron homeostasis and distal colorectal adenoma risk in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer Prev Res (Phila) 4(9):1465–1475CrossRef
6.
Wu T, Sempos CT, Freudenheim JL, Muti P, Smit E (2004) Serum iron, copper and zinc concentrations and risk of cancer mortality in US adults. Ann Epidemiol 14(3):195–201PubMedCrossRef
7.
Li F, Kishida T, Kobayashi M (1999) Serum iron and ferritin levels in patients with colorectal cancer in relation to the size, site, and disease stage of cancer. J Gastroenterol 34(2):195–199PubMedCrossRef
8.
Kooistra MP, Niemantsverdriet EC, van Es A, Mol-Beermann NM, Struyvenberg A, Marx JJ (1998) Iron absorption in erythropoietin-treated haemodialysis patients: effects of iron availability, inflammation and aluminium. Nephrol Dial Transpl 13(1):82–88CrossRef
9.
Van Hemelrijck M, Holmberg L, Garmo H, Hammar N, Walldius G, Binda E et al (2011) Association between levels of C-reactive protein and leukocytes and cancer: three repeated measurements in the Swedish AMORIS study. Cancer Epidemiol Biomarkers Prev 20(3):428–437PubMedCrossRef
10.
Rajamaki A, Irjala K, Aitio A (1979) Immunochemical determination of serum transferrin. Reference values, correlation with serum total iron-binding capacity and value in the diagnosis of iron deficiency anaemia and anaemia of chronic disorders. Scandinavian J Haematol 23(3):227–231CrossRef
11.
Walldius G, Jungner I, Holme I, Aastveit AH, Kolar W, Steiner E (2001) High apolipoprotein B, low apolipoprotein A-I, and improvement in the prediction of fatal myocardial infarction (AMORIS study): a prospective study. Lancet 358(9298):2026–2033PubMedCrossRef
12.
Jungner I, Marcovina SM, Walldius G, Holme I, Kolar W, Steiner E (1998) Apolipoprotein B and A-I values in 147576 Swedish males and females, standardized according to the world health organization-international federation of clinical chemistry first international reference materials. Clin Chem 44(8 Pt 1):1641–1649PubMed
13.
Holme I, Aastveit AH, Jungner I, Walldius G (2008) Relationships between lipoprotein components and risk of myocardial infarction: age, gender and short versus longer follow-up periods in the apolipoprotein mortality risk study (AMORIS). J Intern Med 264(1):30–38PubMedCrossRef
14.
Holme I, Aastveit AH, Hammar N, Jungner I, Walldius G (2009) Relationships between lipoprotein components and risk of ischaemic and haemorrhagic stroke in the apolipoprotein mortality risk study (AMORIS). J Intern Med 265(2):275–287PubMedCrossRef
15.
Walldius G, Jungner I, Kolar W, Holme I, Steiner E (1992) High cholesterol and triglyceride values in Swedish males and females: increased risk of fatal myocardial infarction. First report from the AMORIS (Apolipoprotein related mortality risk) study. Blood Press Suppl 4:35–42PubMed
16.
Van Hemelrijck M, Garmo H, Binda E, Hayday A, Karagiannis SN, Hammar N et al (2010) Immunoglobulin E and cancer: a meta-analysis and a large Swedish cohort study. Cancer Causes Control 21:1657–1667PubMedCrossRef
17.
Van Hemelrijck M, Garmo H, Holmberg L, Walldius G, Jungner I, Hammar N, Lambe M (2011) Prostate cancer risk in the Swedish AMORIS study: the interplay among triglycerides, total cholesterol, and glucose. Cancer 117(10):2086–2095
18.
Central Bureau for Statistics. Statistics Sweden. Stockholm SAfhwss
19.
Wilkins J, Gallimore JR, Moore EG, Pepys MB (1998) Rapid automated high sensitivity enzyme immunoassay of C-reactive protein. Clin Chem 44(6 Pt 1):1358–1361PubMed
20.
Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dagg K, Scott HR (2005) A prospective longitudinal study of performance status, an inflammation-based score (GPS) and survival in patients with inoperable non-small-cell lung cancer. Br J Cancer 92(10):1834–1836PubMedCrossRef
21.
Proctor MJ, Talwar D, Balmar SM, O’Reilly DS, Foulis AK, Horgan PG et al (2010) The relationship between the presence and site of cancer, an inflammation-based prognostic score and biochemical parameters. Initial results of the Glasgow inflammation outcome study. Br J Cancer 103(6):870–876PubMedCrossRef
22.
Bengtsson C, Lindquist O, Redvall L (1981) Menstrual status and menopausal age of middle-aged Swedish women. A population study of women in Goteborg 1968–1969 and 1974–1975. Acta Obstet Gynecol Scand 60(3):269–275PubMedCrossRef
23.
Lambe M, Wigertz A, Garmo H, Walldius G, Jungner I, Hammar N (2011) Impaired glucose metabolism and diabetes and the risk of breast, endometrial, and ovarian cancer. Cancer Causes Control 22(8):1163–1171PubMedCrossRef
24.
Holzmann M, Jungner I, Walldius G, Ivert I, Nordqvist T, Östergren J (2008) Apolipoproteins B and A-I, standard lipid measures and incidence of myocardial infarction in men and women, with or without chronic kidney disease. Study IV in thesis for doctorial degree (Ph.D.). In: Holzmann M (ed) Renal insufficiency, mortality and myocardial infarction, Stockholm, Karolinska Institutet
25.
Vanarsa K, Ye Y, Han J, Xie C, Mohan C, Wu T (2012) Inflammation associated anemia and ferritin as disease markers in SLE. Arthritis Res Ther 14(4):R182PubMedCrossRef
Metadata
Title
Iron metabolism and risk of cancer in the Swedish AMORIS study
Authors
Anjali Gaur
Helen Collins
Wahyu Wulaningsih
Lars Holmberg
Hans Garmo
Niklas Hammar
Göran Walldius
Ingmar Jungner
Mieke Van Hemelrijck
Publication date
01-07-2013
Publisher
Springer Netherlands
Published in
Cancer Causes & Control / Issue 7/2013
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-013-0219-8

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