Technical Report No. 14-89

Serum ferritin and stomach cancer risk among A-bomb survivors

Akiba S, Neriishi K, Blot WJ, Kabuto M, Stevens RG, Kato H, Land CE
Editor’s note: A publication based on this report was published in Cancer 67(6):1707-12, 1991.
Summary
Using stored serum samples collected from 1970-72 and/or from 1977-79, serum ferritin, transferrin, and ceruloplasmin levels were immunologically determined for 233 stomach cancer and 84 lung cancer cases diagnosed from 1973-1983 and for 385 matched controls from a fixed population of Hiroshima and Nagasaki A-bomb survivors. Elevated stomach cancer risk was associated with low serum ferritin levels, with more than a threefold excess among those in the lowest quintile as compared to the highest ferritin quintile. The average serum ferritin concenstration was 8% lower in the stomach cancer cases than in the controls. Risk did not vary with the time between blood collection and stomach cancer onset, remaining high among those with low ferritin levels five or more years before cancer diagnosis. Low ferritin combined with achlorhydria, diagnosed about 10 years before the blood collection and up to 25 years before cancer diagnosis, was an exceptionally strong marker of increased stomach cancer risk. No effect of transferrin or ceruloplasmin independent of ferritin was observed on gastric cancer risk. Lung cancer risk was not related to these three serum proteins.

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