Body iron status and gastric cancer risk in the EURGAST study
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Accepted version
Author(s)
Type
Journal Article
Abstract
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 µg/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.
Date Issued
2015-07-01
Date Acceptance
2015-05-28
Citation
International Journal of Cancer, 2015, 137 (12), pp.2904-2914
ISSN
1097-0215
Publisher
Wiley
Start Page
2904
End Page
2914
Journal / Book Title
International Journal of Cancer
Volume
137
Issue
12
Copyright Statement
© 2015 UICC. This is the accepted version of the following article, which has been published in final form at http://dx.doi.org/10.1002/ijc.29669
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000362843300017&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Oncology
iron homeostasis
gastric cancer
nested case-control study
SERUM FERRITIN
STOMACH-CANCER
NUTRITION
STORES
CARCINOGENESIS
WOMEN
MEAT
Adenocarcinoma
Case-Control Studies
Ferritins
Humans
Iron
Risk Factors
Stomach Neoplasms
Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
Publication Status
Published