TY - JOUR
T1 - Risk of cancer by transferrin saturation levels and haemochromatosis genotype
T2 - Population-based study and meta-analysis
AU - Ellervik, C.
AU - Tybjærg-Hansen, A.
AU - Nordestgaard, B. G.
PY - 2012/1/1
Y1 - 2012/1/1
N2 - Objective: Increased iron overload, whether or not owing to the presence of the haemochromatosis genotype C282Y/C282Y, may be associated with an increased risk of cancer. The aim of this study was to test the hypothesis that elevated transferrin saturation levels (as a proxy for iron overload) and haemochromatosis genotype C282Y/C282Y are associated with an increased risk of cancer. Methods: We conducted a population-based study of 8763 individuals, of whom 1417 developed a first cancer during 15years of follow-up, and a meta-analysis. We stratified absolute 10-year risk of cancer by smoking status, an important risk factor. Results: In women, transferrin saturation above 60% versus below 50% was associated with a hazard ratio of 3.6 (95% confidence interval (CI): 2.0-6.5; P<0.001) for any cancer; risk of liver cancer was increased in both women and men. In women, the corresponding absolute 10-year risk of any cancer was 34% and 30% in smokers and nonsmokers, respectively. In men, haemochromatosis genotype C282Y/C282Y versus wild type/wild type was associated with a hazard ratio of 3.7 (95% CI: 1.2-12; P=0.01) for any cancer, with a similar trend in women. In men, the corresponding absolute 10-year risk of cancer was 39% and 27% in smokers and nonsmokers, respectively. Other haemochromatosis genotypes were not associated with increased risk of cancer in women or men. From the meta-analysis, the odds ratio of any cancer for transferrin saturation ≥60% versus a reference group was 1.5 (95% CI: 1.2-1.8) for women and men combined. Conclusions. We have demonstrated that elevated transferrin saturation levels in women and haemochromatosis genotype C282Y/C282Y in men are associated with increased risk of cancer. Thus, our results support the implementation of cancer screening programmes in patients with iron overload or with C282Y/C282Y.
AB - Objective: Increased iron overload, whether or not owing to the presence of the haemochromatosis genotype C282Y/C282Y, may be associated with an increased risk of cancer. The aim of this study was to test the hypothesis that elevated transferrin saturation levels (as a proxy for iron overload) and haemochromatosis genotype C282Y/C282Y are associated with an increased risk of cancer. Methods: We conducted a population-based study of 8763 individuals, of whom 1417 developed a first cancer during 15years of follow-up, and a meta-analysis. We stratified absolute 10-year risk of cancer by smoking status, an important risk factor. Results: In women, transferrin saturation above 60% versus below 50% was associated with a hazard ratio of 3.6 (95% confidence interval (CI): 2.0-6.5; P<0.001) for any cancer; risk of liver cancer was increased in both women and men. In women, the corresponding absolute 10-year risk of any cancer was 34% and 30% in smokers and nonsmokers, respectively. In men, haemochromatosis genotype C282Y/C282Y versus wild type/wild type was associated with a hazard ratio of 3.7 (95% CI: 1.2-12; P=0.01) for any cancer, with a similar trend in women. In men, the corresponding absolute 10-year risk of cancer was 39% and 27% in smokers and nonsmokers, respectively. Other haemochromatosis genotypes were not associated with increased risk of cancer in women or men. From the meta-analysis, the odds ratio of any cancer for transferrin saturation ≥60% versus a reference group was 1.5 (95% CI: 1.2-1.8) for women and men combined. Conclusions. We have demonstrated that elevated transferrin saturation levels in women and haemochromatosis genotype C282Y/C282Y in men are associated with increased risk of cancer. Thus, our results support the implementation of cancer screening programmes in patients with iron overload or with C282Y/C282Y.
KW - Cancer
KW - Follow-up
KW - Haemochromatosis genotype
KW - Meta-analysis
KW - Transferrin saturation
UR - http://www.scopus.com/inward/record.url?scp=83855165812&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2796.2011.02404.x
DO - 10.1111/j.1365-2796.2011.02404.x
M3 - Article
C2 - 21605201
AN - SCOPUS:83855165812
SN - 0954-6820
VL - 271
SP - 51
EP - 63
JO - Journal of Internal Medicine
JF - Journal of Internal Medicine
IS - 1
ER -