The Association between Hemoglobin Level and Cancer Incidence, Mortality and Inflammatory Biomarkers in Post-Menopausal Women

Persistent Link:
http://hdl.handle.net/10150/301693
Title:
The Association between Hemoglobin Level and Cancer Incidence, Mortality and Inflammatory Biomarkers in Post-Menopausal Women
Author:
Grant, Andriene Simone
Issue Date:
2013
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Background: Knowledge regarding the associations of (i) hemoglobin level (Hb) prior to cancer diagnosis and cancer mortality (ii) the full range of Hb and cancer incidence and (iii) baseline inflammatory/other biomarkers and Hb in older populations is limited. The present study examined the associations of anemia status/Hb with cancer incidence and mortality, as well as the association with inflammatory biomarker levels in post-menopausal women. Methods: Anemia was defined as Hb <1 2 g/dl, while high Hb was defined as Hb >= 15 g/dl, or >= 16 g/dl. Associations were determined in three Women's Health Initiative Study sub-populations. The association between anemia/Hb with cancer mortality was determined in women without (N=21,021) or with (N=2,976) cancer history who had cancers on follow-up. The cross-sectional association of biomarkers and anemia/Hb was determined on 1,001 women with these available data. Finally, the association between anemia/Hb with cancer incidence was determined in women enrolled in the Observational Study/Clinical Trial who did not have a history of cancer/extreme energy intakes/missing follow-up time (N=140,269). Results: Anemia was associated with a 21% higher hazard of total cancer death in participants with, and a 55% greater hazard in participants without cancer history. Anemic women with a history of cancer had twice the hazard of colorectal cancer death. C-reactive protein, TNF-alpha, TNF-beta and TNFR2 were significantly associated with anemia. IL-1 alpha and IL-10 were significantly associated with continuous Hb. Anemia was not associated with cancer incidence in the total population, but anemic African-American women had a reduced risk of any cancer incidence which was not observed in white women (p-interaction=0.03). Women with high Hb had an increased hazard of any (HR: 1.37; 95% CI: 1.17, 1.60) or breast cancer (HR: 1.42; 95% CI: 1.10, 1.84) incidence. Conclusions: Anemia determined prior to cancer diagnosis was associated with total and colorectal cancer death. High Hb was associated with increased risk of total cancer and breast cancer incidence. Anemia was associated with elevated levels of C-reactive protein, TNF-alpha, TNF-beta and TNFR2, while continuous Hb was associated with IL-1 alpha and IL-10. Further research is required to confirm associations and clarify causal mechanisms.
Type:
text; Electronic Dissertation
Keywords:
cancer; hemoglobin; incidence; inflammation; mortality; Epidemiology; anemia
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Graduate College; Epidemiology
Degree Grantor:
University of Arizona
Advisor:
Chen, Zhao

Full metadata record

DC FieldValue Language
dc.language.isoenen_US
dc.titleThe Association between Hemoglobin Level and Cancer Incidence, Mortality and Inflammatory Biomarkers in Post-Menopausal Womenen_US
dc.creatorGrant, Andriene Simoneen_US
dc.contributor.authorGrant, Andriene Simoneen_US
dc.date.issued2013-
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractBackground: Knowledge regarding the associations of (i) hemoglobin level (Hb) prior to cancer diagnosis and cancer mortality (ii) the full range of Hb and cancer incidence and (iii) baseline inflammatory/other biomarkers and Hb in older populations is limited. The present study examined the associations of anemia status/Hb with cancer incidence and mortality, as well as the association with inflammatory biomarker levels in post-menopausal women. Methods: Anemia was defined as Hb <1 2 g/dl, while high Hb was defined as Hb >= 15 g/dl, or >= 16 g/dl. Associations were determined in three Women's Health Initiative Study sub-populations. The association between anemia/Hb with cancer mortality was determined in women without (N=21,021) or with (N=2,976) cancer history who had cancers on follow-up. The cross-sectional association of biomarkers and anemia/Hb was determined on 1,001 women with these available data. Finally, the association between anemia/Hb with cancer incidence was determined in women enrolled in the Observational Study/Clinical Trial who did not have a history of cancer/extreme energy intakes/missing follow-up time (N=140,269). Results: Anemia was associated with a 21% higher hazard of total cancer death in participants with, and a 55% greater hazard in participants without cancer history. Anemic women with a history of cancer had twice the hazard of colorectal cancer death. C-reactive protein, TNF-alpha, TNF-beta and TNFR2 were significantly associated with anemia. IL-1 alpha and IL-10 were significantly associated with continuous Hb. Anemia was not associated with cancer incidence in the total population, but anemic African-American women had a reduced risk of any cancer incidence which was not observed in white women (p-interaction=0.03). Women with high Hb had an increased hazard of any (HR: 1.37; 95% CI: 1.17, 1.60) or breast cancer (HR: 1.42; 95% CI: 1.10, 1.84) incidence. Conclusions: Anemia determined prior to cancer diagnosis was associated with total and colorectal cancer death. High Hb was associated with increased risk of total cancer and breast cancer incidence. Anemia was associated with elevated levels of C-reactive protein, TNF-alpha, TNF-beta and TNFR2, while continuous Hb was associated with IL-1 alpha and IL-10. Further research is required to confirm associations and clarify causal mechanisms.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectcanceren_US
dc.subjecthemoglobinen_US
dc.subjectincidenceen_US
dc.subjectinflammationen_US
dc.subjectmortalityen_US
dc.subjectEpidemiologyen_US
dc.subjectanemiaen_US
thesis.degree.namePh.D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.disciplineEpidemiologyen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorChen, Zhaoen_US
dc.contributor.committeememberHsu, Paulen_US
dc.contributor.committeememberThompson, Patriciaen_US
dc.contributor.committeememberErnst, Kaceyen_US
dc.contributor.committeememberChen, Zhaoen_US
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