title: Inorganic phosphate and the risk of cancer in the Swedish AMORIS study.
abstract: BACKGROUND
  Both dietary and serum levels of inorganic phosphate (Pi) have been linked to development of cancer in experimental studies. This is the first population-based study investigating the relation between serum Pi and risk of cancer in humans.
  
  
  METHODS
  From the Swedish Apolipoprotein Mortality Risk (AMORIS) study, we selected all participants (> 20 years old) with baseline measurements of serum Pi, calcium, alkaline phosphatase, glucose, and creatinine (n = 397,292). Multivariable Cox proportional hazards regression analyses were used to assess serum Pi in relation to overall cancer risk. Similar analyses were performed for specific cancer sites.
  
  
  RESULTS
  We found a higher overall cancer risk with increasing Pi levels in men ( HR: 1.02 (95% CI: 1.00-1.04) for every SD increase in Pi), and a negative association in women (HR: 0.97 (95% CI: 0.96-0.99) for every SD increase in Pi). Further analyses for specific cancer sites showed a positive link between Pi quartiles and the risk of cancer of the pancreas, lung, thyroid gland and bone in men, and cancer of the oesophagus, lung, and nonmelanoma skin cancer in women. Conversely, the risks for developing breast and endometrial cancer as well as other endocrine cancer in both men and women were lower in those with higher Pi levels.
  
  
  CONCLUSIONS
  Abnormal Pi levels are related to development of cancer. Furthermore, the in verse association between Pi levels and risk of breast, endometrial and other endocrine cancers may indicate the role of hormonal factors in the relation between Pi metabolism and cancer.
authors.affiliation: King's College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Unit, London, UK.
authors.forename: Wahyu
authors.initials: W
authors.lastname: Wulaningsih
authors.forename: Karl
authors.initials: K
authors.lastname: Michaelsson
authors.forename: Hans
authors.initials: H
authors.lastname: Garmo
authors.forename: Niklas
authors.initials: N
authors.lastname: Hammar
authors.forename: Ingmar
authors.initials: I
authors.lastname: Jungner
authors.forename: Göran
authors.initials: G
authors.lastname: Walldius
authors.forename: Lars
authors.initials: L
authors.lastname: Holmberg
authors.forename: Mieke
authors.initials: M
authors.lastname: Van Hemelrijck
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000453:epidemiology*; D010710:Phosphates / Q000097:blood*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D010710:Phosphates