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Dietary intake of heme iron and risk of gastric cancer in the European prospective investigation into cancer and nutrition study.
Jakszyn, Paula 14; Agudo, Antonio 1; Lujan-Barroso, Leila 1; Bueno-de-Mesquita, H Bas 2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21; Jenab, Mazda 3; Navarro, Carmen 4; Palli, Domenico 5; Boeing, Heiner 6; Manjer, Jonas 7; Numans, Mattijs E 8; Igali, Laszlo 9; Boutron-Ruault, Marie-Christine 10; Clavel-Chapelon, Francoise 10; Morois, Sophie 10; Grioni, Sara 11; Panico, cSalvatore 12; Tumino, Rosario 13; Sacerdote, Carlotta 14; Quiros, Ramon J. 15; Molina-Montes, Esther 16; Ma Huerta Castano, Jose 4; Barricarte, Aurelio 17; Amiano, Pilar 18; Khaw, Kay-Tee 19; Wareham, Nicholas 19; Allen, Naomi E. 20; Key, Timothy J 20; Jeurnink, Suzanne M. 2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21; Peeters, Petra HM 8; Bamia, Christina 22; Valanou, Elisabeth 22,23; Trichopoulou, Antonia 22,23; Kaaks, Rudolf 24; Lukanova, Annekatrin 24; Bergmann, Manuela M. 6; Lindkvist, Bjorn 25; Stenling, Roger 26; Johansson, Ingegerd 27; Dahm, Christina C. 28,29; Overvad, Kim 29; Olsen, Anja 30; Tjonneland, Anne 30; Skeie, Guri 31; Ragnhild Broderstad, Ann 31; Lund, Eiliv 31; Michaud, Dominique S. 32; Mouw, Traci 32; Riboli, Elio 33; Gonzalez, Carlos A 1
[Miscellaneous Article] International Journal Of Cancer. 130(11):2654-2663, June 1, 2012.

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Even though recent studies suggest that a high intake of heme iron is associated with several types of cancer, epidemiological studies in relation to gastric cancer (GC) are lacking. Our previous results show a positive association between red and processed meat and non cardia gastric cancer, especially in Helicobacter pylori infected subjects. The aim of the study is to investigate the association between heme iron intake and GC risk in the European prospective investigation into cancer and nutrition (EURGAST-EPIC). Dietary intake was assessed by validated center-specific questionnaires. Heme iron was calculated as a type-specific percentage of the total iron content in meat intake, derived from the literature. Antibodies of H. pylori infection and vitamin C levels were measured in a sub-sample of cases and matched controls included in a nested case-control study within the cohort. The study included 481,419 individuals and 444 incident cases of GC that occurred during an average of 8.7 years of followup. We observed a statistically significant association between heme iron intake and GC risk (HR 1.13 95% CI: 1.01-1.26 for a doubling of intake) adjusted by sex, age, BMI, education level, tobacco smoking and energy intake. The positive association between heme iron and the risk of GC was statistically significant in subjects with plasma vitamin C <39 mmol/l only (log2 HR 1.54 95% CI (1.01-2.35). We found a positive association between heme iron intake and gastric cancer risk.