A prospective cohort examination of haematological parameters in relation to cancer death and incidence: the Busselton Health Study

Abstract

BackgroundCancer risk is associated with serum iron levels. The aim of this study was to evaluate whether haematological parameters reflect serum iron levels and may also be associated with cancer risk.MethodsWe studied 1564 men and 1769 women who were enrolled in the Busselton Health Study, Western Australia. Haematological parameters evaluated included haemoglobin (Hb), mean cell volume (MCV), mean cell haemoglobin (MCH) and mean cell haemoglobin concentration (MCHC) and red cell distribution width (RCDW). Statistical analyses included t-tests for quantitative variables, chi-square tests for categorical variables and Cox proportional hazards regression modelling for cancer incidence and death.ResultsThere was marginal evidence of an association between MCV (as a continuous variable) and non-skin cancer incidence in women (HR 1.15, 95% CI 1.013, 1.302; p = 0.030) but the hazard ratio was attenuated to non-significance after adjustment for serum ferritin (SF), iron and transferrin saturation (TS) (HR 1.11, 95% CI 0.972, 1.264; p = 0.126). There was strong evidence of an association between MCHC and prostate cancer incidence in men; the estimated hazard ratio for an increase of one SD (0.5) in MCHC was 1.27 (95% CI 1.064, 1.507; p = 0.008). These results remained significant after further adjustment for SF and iron; the estimated hazard ratio for an increase of one SD (0.5) in MCHC was 1.25 (p = 0.014, 95% CI 1.05 to 1.48).ConclusionsThe MCHC and MCV were associated with cancer incidence in a Western Australian population, although only MCHC remained associated with prostate cancer after adjusting with serum iron and TS (circulating iron) and SF (storage iron). Haematological parameters are thus of limited utility in population profiling for future cancer risk.

Preoperative ultrasound combined with routine blood tests in predicting the malignant risk of pancreatic cystic neoplasms

“…MCH and MCHC reflect rapid compensatory regeneration of the bone marrow caused by hemolysis and anemia. Male patients with high MCHC have a significantly higher risk of developing prostate cancerr 38 , in agreement with our findings that high MCHC is an independent risk factor for malignant PCN. The mechanisms involved in the pathological elevation of MCHC and tumorigenesis are not well understood, but may possibly be a consequence of the long-term effects of iron-dependent oxidative stress on erythrocyte structure and cancer pathogenesis 39 .…”

Hematologic Markers and Prostate Cancer Risk: A Prospective Analysis in UK Biobank

“…Although some prospective studies have previously examined the associations between a limited number of hematologic parameters and overall cancer risk (19)(20)(21)(22)(23), few have had the power to examine these exposures in relation to prostate cancer diagnosis or mortality (19,20,24). Moreover, these studies have relied on a single measure at study baseline.…”

Association between Hemoglobin Levels and Colorectal Polyps in Asymptomatic Chinese Adults

“…Although the mechanism linking high hemoglobin levels and colorectal polyps is unclear, there are several probable explanations. One possible reason is that the presence of high levels of hemoglobin, an iron-containing metalloprotein, causes iron-induced oxidative stress and relative antioxidant depletion; this process has been shown to promote carcinogenesis [22,23]. This hypothesis may support the possibility that elevated hemoglobin levels act as additive factors in the formation of colonic adenomas and their transformation into carcinomas via the adenoma-carcinoma sequence.…”