Dietary intake of iron, heme-iron and magnesium and pancreatic cancer risk in the European prospective investigation into cancer and nutrition cohort.
Level 3 - non-randomized controlled study
Prospective multicenter cohort study
PubMed 22438075 · doi:10.1002/ijc.27547
What was done
Dietary intake of magnesium, total iron, and heme-iron was evaluated for association with exocrine pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 142,203 men and 334,999 women recruited between 1992 and 2000. Over an average follow-up of 11.3 years, 396 men and 469 women developed exocrine pancreatic cancer. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression stratified by age and center, adjusted for total energy intake, smoking status, height, weight, and self-reported diabetes status, alongside calibrated dietary models.
What was found
Overall, neither magnesium, total iron, nor heme-iron intake was associated with pancreatic cancer risk. In subgroup analyses, a borderline inverse association was observed for magnesium intake among overweight men with BMI ≥ 25 kg/m² (HR per 100 mg/day increase = 0.79, 95% CI: 0.63–1.01), though this was less apparent using calibrated intake. In female smokers, higher heme-iron intake was associated with increased pancreatic cancer risk (HR per 1 mg/day increase = 1.38, 95% CI: 1.10–1.74), which increased after calibration (HR = 2.5, 95% CI: 1.22–5.28).
Why it matters
These findings suggest that dietary iron and magnesium are not major independent drivers of pancreatic cancer risk in the general European population, though the interaction between heme-iron and smoking warrants further study.
Limits
Dietary intake was based on baseline self-reports subject to measurement error. Subgroup findings in female smokers and overweight men are post-hoc or stratified comparisons susceptible to multiple testing and residual confounding.
Cited by
- context For every 100 mg decrease in magnesium intake, there is a 24% increase in the incidence of pancreatic cancer.