Body iron status and gastric cancer risk in the EURGAST study

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Title: Body iron status and gastric cancer risk in the EURGAST study
Authors: Fonseca-Nunes, A
Agudo, A
Aranda, N
Arija, V
Cross, AJ
Molina, E
Jose Sanchez, M
Bueno-de-Mesquita, HBA
Siersema, P
Weiderpass, E
Krogh, V
Mattiello, A
Tumino, R
Saieva, C
Naccarati, A
Ohlsson, B
Sjoberg, K
Boutron-Ruault, M-C
Cadeau, C
Fagherazzi, G
Boeing, H
Steffen, A
Kuehn, T
Katzke, V
Tjonneland, A
Olsen, A
Khaw, K-T
Wareham, N
Key, T
Lu, Y
Riboli, E
Peeters, PH
Gavrila, D
Dorronsoro, M
Ramon Quiros, J
Barricarte, A
Jenab, M
Zamora-Ros, R
Freisling, H
Trichopoulou, A
Lagiou, P
Bamia, C
Jakszyn, P
Item 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.
Issue Date: 1-Jul-2015
Date of Acceptance: 28-May-2015
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
Keywords: Science & Technology
Life Sciences & Biomedicine
iron homeostasis
gastric cancer
nested case-control study
Case-Control Studies
Risk Factors
Stomach Neoplasms
Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
Publication Status: Published
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care

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