Cancer Causes & Control

, 22:1627 | Cite as

A prospective study of intakes of zinc and heme iron and colorectal cancer risk in men and women

  • Xuehong ZhangEmail author
  • Edward L. Giovannucci
  • Stephanie A. Smith-Warner
  • Kana Wu
  • Charles S. Fuchs
  • Michael Pollak
  • Walter C. Willett
  • Jing Ma
Original paper


Although laboratory studies linked zinc and heme iron to colorectal cancer, epidemiologic evidence is limited. We prospectively examined these associations in the Nurses’ Health Study and Health Professionals Follow-up Study. We used Cox proportional hazards regression analyses to calculate cohort-specific relative risks (RRs) and pooled results using a fixed-effects model. We documented 2,114 incident colorectal cancer cases during up to 22 years of follow-up. Compared highest to lowest quintile of dietary zinc intake, the pooled multivariable RRs (95% CIs) were 0.86 (0.73, 1.02) for colorectal cancer, 0.92 (0.76, 1.11) for colon cancer, and 0.68 (0.47, 0.99) for rectal cancer. The significant inverse association between dietary zinc intake and risk of rectal cancer was mainly driven by data in women, although the difference in the sex-specific results was not statistically significant. For the same comparison, the pooled multivariable RRs (95% CIs) for heme iron were 1.10 (0.93, 1.30) for colorectal cancer, 1.06 (0.88, 1.29) for colon cancer, and 1.20 (0.83, 1.75) for rectal cancer. These associations were not significantly modified by alcohol consumption, body mass index, physical activity, menopausal status, or postmenopausal hormone use. Total zinc intake, total iron intake, dietary iron intake, and zinc or iron supplement uses were largely not associated with colorectal cancer risk. Our study does not support strong roles of zinc and heme iron intake in colorectal cancer risk; however, a suggestive inverse association of dietary zinc intake with rectal cancer risk in women requires further study.


Colorectal cancer Zinc Iron Heme iron Cohort study 



We are grateful for all participants in the Nurses’ Health Study and Health Professionals Follow-up Study for their continuous contribution and support. This work was supported by the NIH grants CA87969 and CA55075.

Conflict of interest

None. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.


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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Xuehong Zhang
    • 1
    Email author
  • Edward L. Giovannucci
    • 1
    • 2
    • 3
  • Stephanie A. Smith-Warner
    • 2
    • 3
  • Kana Wu
    • 2
  • Charles S. Fuchs
    • 1
    • 4
  • Michael Pollak
    • 5
  • Walter C. Willett
    • 1
    • 2
    • 3
  • Jing Ma
    • 1
  1. 1.Channing Laboratory at Landmark Center (West Wing), Department of MedicineBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Department of NutritionHarvard School of Public HealthBostonUSA
  3. 3.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  4. 4.Department of Medical OncologyDana-Farber Cancer Institute, Harvard Medical SchoolBostonUSA
  5. 5.Department of OncologyMcGill University and Lady Davis Research InstituteMontrealCanada

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