Christina C. Dahm

Haem iron intake and risk of lung cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Heather A Ward, School of Public Health, Imperial College London, London, UK. heather.ward@imperial.ac.uk., United Kingdom
  • Julia Whitman, School of Public Health, Imperial College London, London, England., United Kingdom
  • David C Muller, School of Public Health, Imperial College London, London, England., United Kingdom
  • Mattias Johansson, International Agency for Research on Cancer, Lyon, France., France
  • Paula Jakszyn, Unit Nutrition, Environment and Cancer, Department of Epidemiology, Catalan Institute of Oncology, Barcelona, Spain., Spain
  • Elisabete Weiderpass, University of Tromsø, Department of Research, Cancer Registry of Norway, Institute of Population‐Based Cancer Research, Oslo, Norway, Karolinska Institutet, University of Helsinki, Finland
  • Domenico Palli, Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy., Italy
  • Anouar Fanidi, International Agency for Research on Cancer, Lyon, France., France
  • Roel Vermeulen, Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands., Netherlands
  • Anne Tjønneland, Danish Cancer Society Research Centre, Danish Cancer Society, Copenhagen, Denmark., Denmark
  • Louise Hansen, Danish Cancer Society Research Centre, Danish Cancer Society, Copenhagen, Denmark., Denmark
  • Christina C Dahm
  • Kim Overvad
  • Gianluca Severi, Human Genetics Foundation, Universite Paris-Saclay, France
  • Marie-Christine Boutron-Ruault, CESP Inserm, Facultés de Medicine Université Paris-Sud, UVSQ, Université Paris-Saclay, Gustave Roussy, Villejuif, France., France
  • Aurélie Affret, CESP Inserm, Facultés de Medicine Université Paris-Sud, UVSQ, Université Paris-Saclay, Gustave Roussy, Villejuif, France., France
  • Rudolf Kaaks, Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany., Germany
  • Renee Fortner, Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany., Germany
  • Heiner Boeing, Department of Epidemiology, German Institute of Human Nutrition (DIfE) 14558 Potsdam-Rehbrücke, Nuthetal, Germany., Germany
  • Antonia Trichopoulou, Hellenic Health Foundation, Athens, Greece., National and Kapodistrian University of Athens, Greece
  • Carlo La Vecchia, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy., Hellenic Health Foundation, Athens, Greece., Italy
  • Anastasia Kotanidou, 1st Department of Critical Care Medicine & Pulmonary Services, University of Athens Medical School, Evangelismos Hospital, 10675 Athens, Greece. akotanid@gmail.com., Hellenic Health Foundation, Athens, Greece., Greece
  • Franco Berrino, Fondazione IRCCS National Cancer Institute, Milan, Italy., Italy
  • Vittorio Krogh, Fondazione IRCCS National Cancer Institute, Milan, Italy., Italy
  • Rosario Tumino, Cancer Registry and Histopathology Unit, "Civic - M.p.Arezzo" Hospital, ASP Ragusa, Italy., Italy
  • Fulvio Ricceri, Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco (TO), Italy., Italy
  • Salvatore Panico, Department of Clinical Medicine and Surgery, Division of Gastroenterology, Federico II University Hospital School of Medicine, Naples, Italy., Italy
  • H Bas Bueno-de-Mesquita, Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands., Imperial College London, Netherlands
  • Petra H Peeters, Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK., Netherlands
  • Therese Haugdahl Nøst, Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway., Norway
  • Torkjel M Sandanger, Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway., Norway
  • Jose Ramón Quirós, Public Health Directorate, Asturias, Spain., Spain
  • Antonio Agudo, Unit of Nutrition and Cancer. Cancer Epidemiology Research Program. Catalan Institute of Oncology-IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain., Spain
  • Miguel Rodríguez-Barranco, Consortium for Biomedical Research in Epidemiology and Public Health (CIBER- CIBERESP), 28029 Madrid, Spain., Universidad de Granada, Spain
  • Nerea Larrañaga, Public Health Division and BioDonostia Research Institute and CIBERESP, Basque Regional Health Department, San Sebastian, Spain., CIBER Epidemiology and Public Health CIBERESP, Spain
  • Jose Maria Huerta, Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain., CIBER Epidemiology and Public Health CIBERESP, Spain
  • Eva Ardanaz, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain., Biodonostia Health Research Institute, Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain., CIBER Epidemiology and Public Health CIBERESP, Spain
  • Isabel Drake, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden., Sweden
  • Hans Brunnström, Lund University, Sweden
  • Mikael Johansson, Public Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden., Sweden
  • Kjell Grankvist, Department of Medical Biosciences/Clinical Chemistry, Umeå University, Umeå, Sweden, Sweden
  • Ruth C Travis, Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., United Kingdom
  • Heinz Freisling, International Agency for Research on Cancer, Lyon, France., France
  • Magdalena Stepien, International Agency for Research on Cancer, Lyon, France., France
  • Melissa A Merritt, School of Public Health, Imperial College London, London, England., United Kingdom
  • Elio Riboli, School of Public Health, Imperial College London, London, England., United Kingdom
  • Amanda J Cross, School of Public Health, Imperial College London, London, England., United Kingdom

BACKGROUND: Epidemiological studies suggest that haem iron, which is found predominantly in red meat and increases endogenous formation of carcinogenic N-nitroso compounds, may be positively associated with lung cancer. The objective was to examine the relationship between haem iron intake and lung cancer risk using detailed smoking history data and serum cotinine to control for potential confounding.

METHODS: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 416,746 individuals from 10 countries completed demographic and dietary questionnaires at recruitment. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident lung cancer (n = 3731) risk relative to haem iron, non-haem iron, and total dietary iron intake. A corresponding analysis was conducted among a nested subset of 800 lung cancer cases and 1489 matched controls for whom serum cotinine was available.

RESULTS: Haem iron was associated with lung cancer risk, including after adjustment for details of smoking history (time since quitting, number of cigarettes per day): as a continuous variable (HR per 0.3 mg/1000 kcal 1.03, 95% CI 1.00-1.07), and in the highest versus lowest quintile (HR 1.16, 95% CI 1.02-1.32; trend across quintiles: P = 0.035). In contrast, non-haem iron intake was related inversely with lung cancer risk; however, this association attenuated after adjustment for smoking history. Additional adjustment for serum cotinine did not considerably alter the associations detected in the nested case-control subset.

CONCLUSIONS: Greater haem iron intake may be modestly associated with lung cancer risk.

Original languageEnglish
JournalEuropean Journal of Clinical Nutrition
Volume73
Issue8
Pages (from-to)1122-1132
Number of pages11
ISSN0954-3007
DOIs
Publication statusPublished - Aug 2019

    Research areas

  • haem iron, non-haem iron, dietary iron, lung cancer, cohort, EPIC, cotinine

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