Dietary intake of total, heme and non-heme iron and the risk of colorectal cancer in a European prospective cohort study
(2023) In British Journal of Cancer 128(8). p.1529-1540- Abstract
Background: Iron is an essential micronutrient with differing intake patterns and metabolism between men and women. Epidemiologic evidence on the association of dietary iron and its heme and non-heme components with colorectal cancer (CRC) development is inconclusive. Methods: We examined baseline dietary questionnaire-assessed intakes of total, heme, and non-heme iron and CRC risk in the EPIC cohort. Sex-specific multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were computed using Cox regression. We modelled substitution of a 1 mg/day of heme iron intake with non-heme iron using the leave one-out method. Results: Of 450,105 participants (318,680 women) followed for 14.2 ± 4.0 years, 6162 (3511 women)... (More)
Background: Iron is an essential micronutrient with differing intake patterns and metabolism between men and women. Epidemiologic evidence on the association of dietary iron and its heme and non-heme components with colorectal cancer (CRC) development is inconclusive. Methods: We examined baseline dietary questionnaire-assessed intakes of total, heme, and non-heme iron and CRC risk in the EPIC cohort. Sex-specific multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were computed using Cox regression. We modelled substitution of a 1 mg/day of heme iron intake with non-heme iron using the leave one-out method. Results: Of 450,105 participants (318,680 women) followed for 14.2 ± 4.0 years, 6162 (3511 women) developed CRC. In men, total iron intake was not associated with CRC risk (highest vs. lowest quintile, HRQ5vs.Q1:0.88; 95%CI:0.73, 1.06). An inverse association was observed for non-heme iron (HRQ5vs.Q1:0.80, 95%CI:0.67, 0.96) whereas heme iron showed a non-significant association (HRQ5vs.Q1:1.10; 95%CI:0.96, 1.27). In women, CRC risk was not associated with intakes of total (HRQ5vs.Q1:1.11, 95%CI:0.94, 1.31), heme (HRQ5vs.Q1:0.95; 95%CI:0.84, 1.07) or non-heme iron (HRQ5vs.Q1:1.03, 95%CI:0.88, 1.20). Substitution of heme with non-heme iron demonstrated lower CRC risk in men (HR:0.94; 95%CI: 0.89, 0.99). Conclusions: Our findings suggest potential sex-specific CRC risk associations for higher iron consumption that may differ by dietary sources.
(Less)
- author
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- in
- British Journal of Cancer
- volume
- 128
- issue
- 8
- pages
- 1529 - 1540
- publisher
- Nature Publishing Group
- external identifiers
-
- pmid:36759722
- scopus:85147694973
- ISSN
- 0007-0920
- DOI
- 10.1038/s41416-023-02164-7
- language
- English
- LU publication?
- yes
- id
- 1fbd04cf-a8ec-4a65-8b53-54e70b0708fd
- date added to LUP
- 2023-03-08 14:34:52
- date last changed
- 2024-04-18 08:16:23
@article{1fbd04cf-a8ec-4a65-8b53-54e70b0708fd,
abstract = {{<p>Background: Iron is an essential micronutrient with differing intake patterns and metabolism between men and women. Epidemiologic evidence on the association of dietary iron and its heme and non-heme components with colorectal cancer (CRC) development is inconclusive. Methods: We examined baseline dietary questionnaire-assessed intakes of total, heme, and non-heme iron and CRC risk in the EPIC cohort. Sex-specific multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were computed using Cox regression. We modelled substitution of a 1 mg/day of heme iron intake with non-heme iron using the leave one-out method. Results: Of 450,105 participants (318,680 women) followed for 14.2 ± 4.0 years, 6162 (3511 women) developed CRC. In men, total iron intake was not associated with CRC risk (highest vs. lowest quintile, HR<sub>Q5vs.Q1</sub>:0.88; 95%CI:0.73, 1.06). An inverse association was observed for non-heme iron (HR<sub>Q5vs.Q1</sub>:0.80, 95%CI:0.67, 0.96) whereas heme iron showed a non-significant association (HR<sub>Q5vs.Q1</sub>:1.10; 95%CI:0.96, 1.27). In women, CRC risk was not associated with intakes of total (HR<sub>Q5vs.Q1</sub>:1.11, 95%CI:0.94, 1.31), heme (HR<sub>Q5vs.Q1</sub>:0.95; 95%CI:0.84, 1.07) or non-heme iron (HR<sub>Q5vs.Q1</sub>:1.03, 95%CI:0.88, 1.20). Substitution of heme with non-heme iron demonstrated lower CRC risk in men (HR:0.94; 95%CI: 0.89, 0.99). Conclusions: Our findings suggest potential sex-specific CRC risk associations for higher iron consumption that may differ by dietary sources.</p>}},
author = {{Aglago, Elom K. and Cross, Amanda J. and Riboli, Elio and Fedirko, Veronika and Hughes, David J. and Fournier, Agnes and Jakszyn, Paula and Freisling, Heinz and Gunter, Marc J. and Dahm, Christina C. and Overvad, Kim and Tjønneland, Anne and Kyrø, Cecilie and Boutron-Ruault, Marie Christine and Rothwell, Joseph A. and Severi, Gianluca and Katzke, Verena and Srour, Bernard and Schulze, Matthias B. and Wittenbecher, Clemens and Palli, Domenico and Sieri, Sabina and Pasanisi, Fabrizio and Tumino, Rosario and Ricceri, Fulvio and Bueno-De-Mesquita, Bas and Derksen, Jeroen W.G. and Skeie, Guri and Jensen, Torill Enget and Lukic, Marko and Sánchez, Maria Jose and Amiano, Pilar and Colorado-Yohar, Sandra and Barricarte, Aurelio and Ericson, Ulrika and van Guelpen, Bethany and Papier, Keren and Knuppel, Anika and Casagrande, Corinne and Huybrechts, Inge and Heath, Alicia K. and Tsilidis, Konstantinos K. and Jenab, Mazda}},
issn = {{0007-0920}},
language = {{eng}},
number = {{8}},
pages = {{1529--1540}},
publisher = {{Nature Publishing Group}},
series = {{British Journal of Cancer}},
title = {{Dietary intake of total, heme and non-heme iron and the risk of colorectal cancer in a European prospective cohort study}},
url = {{http://dx.doi.org/10.1038/s41416-023-02164-7}},
doi = {{10.1038/s41416-023-02164-7}},
volume = {{128}},
year = {{2023}},
}