TY - JOUR
TI - Body iron status and gastric cancer risk in the EURGAST study
AU - Fonseca-Nunes, Ana
AU - Agudo, Antonio
AU - Aranda, Nuria
AU - Arija,
AU - Victoria
AU - Cross, Amanda J.
AU - Molina, Esther
AU - Jose Sanchez, Maria
AU - and Bueno-de-Mesquita, H. B(as)
AU - Siersema, Peter
AU - Weiderpass,
AU - Elisabete
AU - Krogh, Vittorio
AU - Mattiello, Amalia
AU - Tumino, Rosario
AU - and Saieva, Calogero
AU - Naccarati, Alessio
AU - Ohlsson, Bodil and
AU - Sjoberg, Klas
AU - Boutron-Ruault, Marie-Christine
AU - Cadeau, Claire and
AU - Fagherazzi, Guy
AU - Boeing, Heiner
AU - Steffen, Annika
AU - Kuehn, Tilman
AU - and Katzke, Verena
AU - Tjonneland, Anne
AU - Olsen, Anja
AU - Khaw,
AU - Kay-Tee
AU - Wareham, Nick
AU - Key, Tim
AU - Lu, Yunxia
AU - Riboli, Elio
AU - and Peeters, Petra H.
AU - Gavrila, Diana
AU - Dorronsoro, Miren
AU - Ramon
AU - Quiros, Jose
AU - Barricarte, Aurelio
AU - Jenab, Mazda
AU - Zamora-Ros,
AU - Raul
AU - Freisling, Heinz
AU - Trichopoulou, Antonia
AU - Lagiou, Pagona
AU - and Bamia, Christina
AU - Jakszyn, Paula
JO - International Journal  of Cancer
PY - 2015
VL - 137
TODO - 12
SP - 2904-2914
PB - Wiley
SN - 0020-7136
TODO - 10.1002/ijc.29669
TODO - iron homeostasis; gastric cancer; nested case-control study
TODO - Although it appears biologically plausible for iron to be associated
with gastric carcinogenesis, the evidence is insufficient to lead to any
conclusions. To further investigate the relationship between body iron
status and gastric cancer risk, we conducted a nested case-control study
in the multicentric European Prospective Investigation into Cancer and
Nutrition (EPIC) study. The study included 456 primary incident gastric
adenocarcinoma cases and 900 matched controls that occurred during an
average of 11 years of follow-up. We measured prediagnostic serum iron,
ferritin, transferrin and C-reactive protein, and further estimated
total iron-binding capacity (TIBC) and transferrin saturation (TS). Odds
ratios (ORs) and 95% confidence intervals (CIs) for the risk of gastric
cancer by iron metrics were estimated from multivariable conditional
logistic regression models. After adjusting for relevant confounders, we
observed a statistically significant inverse association between gastric
cancer and ferritin and TS indices (ORlog2=0.80, 95% CI=0.72-0.88;
OR10%increment=0.87, 95% CI=0.78-0.97, respectively). These
associations appear to be restricted to noncardia gastric cancer
(ferritin showed a p for heterogeneity=0.04 and TS had a p for
heterogeneity=0.02), and no differences were found by histological type.
TIBC increased risk of overall gastric cancer (OR50 mu g/dl=1.13, 95%
CI=1.02-1.2) and also with noncardia gastric cancer (p for
heterogeneity=0.04). Additional analysis suggests that time between
blood draw and gastric cancer diagnosis could modify these findings. In
conclusion, our results showed a decreased risk of gastric cancer
related to higher body iron stores as measured by serum iron and
ferritin. Further investigation is needed to clarify the role of iron in
gastric carcinogenesis.
What’s new? Iron is highly reactive, iron levels in the body rise with
inflammation, and the iron-overload disorder hemochromatosis is
associated with an increased risk of gastric cancer. Thus, one might
predict that high levels of iron will increase the risk of cancer.
However, in this study from a large European population, the authors
found that increased body iron stores actually decreased the risk of
gastric cancer. These results suggest that further investigation is
needed to clarify the role of iron in gastric carcinogenesis.
ER -