Iron intake, body iron stores and colorectal cancer risk in women: a nested case-control study

Authors

  • Ikuko Kato,

    Corresponding author
    1. Nelson Institute of Environmental Medicine and Kaplan Comprehensive Cancer Center, New York University School of Medicine, New York, NY, USA
    • Nelson Institute of Environmental Medicine, New York University School of Medicine, 650 First Ave., 5th Floor, New York, NY 10016, USA. Fax: (212) 263-8570.
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  • Ann M. Dnistrian,

    1. Department of Clinical Laboratories, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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  • Morton Schwartz,

    1. Department of Clinical Laboratories, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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  • Paolo Toniolo,

    1. Nelson Institute of Environmental Medicine and Kaplan Comprehensive Cancer Center, New York University School of Medicine, New York, NY, USA
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  • Karen Koenig,

    1. Nelson Institute of Environmental Medicine and Kaplan Comprehensive Cancer Center, New York University School of Medicine, New York, NY, USA
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  • Roy E. Shore,

    1. Nelson Institute of Environmental Medicine and Kaplan Comprehensive Cancer Center, New York University School of Medicine, New York, NY, USA
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  • Anne Zeleniuch-Jacquotte,

    1. Nelson Institute of Environmental Medicine and Kaplan Comprehensive Cancer Center, New York University School of Medicine, New York, NY, USA
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  • Arslan Akhmedkhanov,

    1. Nelson Institute of Environmental Medicine and Kaplan Comprehensive Cancer Center, New York University School of Medicine, New York, NY, USA
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  • Elio Riboli

    1. Unit of Nutrition and Cancer, International Agency for Research on Cancer, Lyon, France
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Abstract

Accumulated evidence suggests that increased body iron stores may increase the risk of colorectal cancer, possibly via catalyzing oxidation reactions. We examined the relationship between iron status and colorectal cancer in a case-control study nested within the New York University Women's Health Study cohort. For 105 incident cases of colorectal cancer with an average follow-up of 4.7 years and 523 individually matched controls, baseline levels of serum iron, ferritin, total iron binding capacity (TIBC) and transferrin saturation were determined as indicators of body iron stores, and total iron intake was assessed based on their diet and supplement intake. Overall, there were no associations between the risk of colorectal cancer and any of these indices except for serum ferritin, which showed a significant inverse association. When analyzed by subsite, there was an increasing trend in risk of cancer of the proximal colon with increasing total iron intake (p-value for trend = 0.04). In addition, a significantly increased risk of colorectal cancer associated with higher total iron intake [odds ratio (OR) = 2.50; 95% confidence interval (CI): 1.06–5.87] was observed among subjects with higher intake of total fat. Our results do not support a role of increased body iron stores in the development of colorectal cancer, but suggest that luminal exposure to excessive iron may possibly increase the risk in combination with a high fat diet. Int. J. Cancer 80:693–698, 1999. © 1999 Wiley-Liss, Inc.

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