title: Iron metabolism and risk of cancer in the Swedish AMORIS study.
abstract: OBJECTIVE
  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.
authors: Division of Cancer Studies, Research Oncology, School of Medicine, King's College London, Guy's Hospital, London, UK. anjali.gaur@kcl.ac.uk
authors: Anjali
authors: A
authors: Gaur
authors: Helen
authors: H
authors: Collins
authors: Wahyu
authors: W
authors: Wulaningsih
authors: Lars
authors: L
authors: Holmberg
authors: Hans
authors: H
authors: Garmo
authors: Niklas
authors: N
authors: Hammar
authors: Göran
authors: G
authors: Walldius
authors: Ingmar
authors: I
authors: Jungner
authors: Mieke
authors: M
authors: Van Hemelrijck
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D007501:Iron / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology* / Q000378:metabolism; D011446:Prospective Studies; D012306:Risk
chemical_list: D002097:C-Reactive Protein; D007501:Iron
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