open access publication

Article, Early Access, 2023

Dietary intake of total, heme and non-heme iron and the risk of colorectal cancer in a European prospective cohort study

BRITISH JOURNAL OF CANCER, ISSN 0007-0920, 0007-0920, 10.1038/s41416-023-02164-7

Contributors

Aglago, Elom K. 0000-0002-0442-3284 [1] [2] [3] Cross, Amanda J. 0000-0001-6001-9211 [1] Cesare, M. D. 0000-0001-6795-6080 [1] Fedirko, Veronika [4] [5] [6] [7] Hughes, David J. [8] Fournier, Agnes [9] [10] [11] [12] Jakszyn, Paula 0000-0003-0672-8847 [13] [14] [15] Freisling, Heinz 0000-0001-8648-4998 [2] [3] Gunter, Marc J. [2] [3] Dahm, C. C. 0000-0003-0481-2893 [16] Overvad, Kim 0000-0001-6429-7921 [16] [17] [18] Tjonneland, Anne 0000-0003-4385-2097 [19] [20] Kyro, Cecilie 0000-0002-9083-8960 [20] Boutron-Ruault, Marie-Christine [9] [10] [11] [12] Rothwell, Joseph A. [9] [10] [11] [12] Severi, Gianluca 0000-0001-7157-419X [9] [10] [11] [12] [21] Katzke, Verena 0000-0002-6509-6555 [22] [23] Srour, Bernard 0000-0002-1277-3380 [22] [23] Schulze, M. B. 0000-0002-0830-5277 [24] [25] Wittenbecher, Clemens 0000-0001-7792-877X [25] [26] [27] [28] Palli, Domenico 0000-0002-5558-2437 [29] Sieri, S. 0000-0001-5201-172X [30] Pasanisi, Fabrizio [31] Tumino, Rosario 0000-0003-2666-414X [32] Ricceri, Fulvio 0000-0001-8749-9737 [33] [34] Bueno-de-Mesquita, Bas [35] Derksen, Jeroen W. G. 0000-0002-2973-5583 [36] [37] Skeie, Guri 0000-0003-2476-4251 [38] Jensen, Torill Enget [38] Lukic, M. [38] Sanchez, Maria-Jose [39] [40] [41] [42] Amiano, Pilar 0000-0003-3986-7026 [42] [43] [44] Colorado-Yohar, Sandra [42] [44] [45] [46] Barricarte, A. [42] [44] [47] [48] [49] Ericson, U. 0000-0003-4629-4318 [50] Van Guelpen, Bethany 0000-0002-9692-101X [51] Papier, Keren [52] Knuppel, Anika 0000-0003-1049-4836 [52] Casagrande, Corinne [2] [3] Huybrechts 0000-0003-3838-855X [2] [3] Heath, Alicia 0000-0001-6517-1300 [1] Tsilidis, Konstantinos K. [1] Jenab, Mazda 0000-0002-0573-1852 (Corresponding author) [2] [3]

Affiliations

  1. [1] Imperial Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England
    2. [NORA names: United Kingdom; Europe, Non-EU; OECD];
  2. [2] Int Agcy Res Canc, Nutr & Metab Branch, Lyon, France
    3. [NORA names: France; Europe, EU; OECD];
  3. [3] Int Agcy Res Canc, Nutr & Metab Branch, Lyon, France
    4. [NORA names: France; Europe, EU; OECD];
  4. [4] Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA USA
    5. [NORA names: United States; America, North; OECD];
  5. [5] Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA USA
    6. [NORA names: United States; America, North; OECD];

Abstract

BackgroundIron 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.MethodsWe 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.ResultsOf 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).ConclusionsOur findings suggest potential sex-specific CRC risk associations for higher iron consumption that may differ by dietary sources.

Data Provider: Clarivate

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