Iodine prophylaxis—the protective factor against stomach cancer in iodine deficient areas



Poland has one of the highest death rates for stomach cancer in Europe. Moderate iodine deficiency and in consequence high goitre prevalence led to the implementation in 1996 of a very efficient mandatory model of iodine prophylaxis, based on household salt iodisation (30 ± 10mg KI/1 kg of salt).

Aim of the study

The aim of the study was evaluation of incidence rate of stomach cancer and its possible relation to increased iodine consumption in the years 1992–2004.


Iodine supply and effectiveness of iodine prophylaxis were evaluated on the basis of comparative analysis of goitre prevalence and ioduria in schoolchildren. To allow comparison between time periods with varying population age structures, the incidence rates of stomach cancer were standardized for age, using the “world standard population”. The direct standardization method has been applied. For each sex, the time-trend of incidence rates was shown in graphs over the years 1991–2004.


Evident increase in iodine consumption in this period of time was proved by rise in percentage of schoolchildren (6–8 years old) with ioduria above 100 µg/l from 11.4% in 1992–1993 to 52.9.1% in 2003. It was correlated with the decrease in goitre prevalence from 18.8% to 3.2% respectively. The 24-h thyroid uptake of 131I in investigated population fell from 45.5% in 1986 to 26.8% in 1998. In Krakow the standardized incidence ratio of stomach cancer for men decreased from 19.1 per 100,000 to 15.7 per 100,000, and for women from 8.3 per 100,000 to 5.9 per 100,000 in the years 1992–2004. A significant decline of average rate of decrease was observed in men and women (2.3% and 4.0% per year respectively).


Observed association between improved iodine supply and decrease of incidence of stomach cancer could indicate the protective role against stomach cancer of iodine prophylaxis in iodine deficient areas—further studies are necessary.

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  1. 1.

    Parkin DM, Muir CS, Whelan SL, Gao YT, Ferlay J, Powell J (1992) Cancer incidence in five continents. Vol. VI. Lyon, France: International Agency for Research on Cancer. IARC Scientific Publications

    Google Scholar 

  2. 2.

    Jedrychowski W, Popiela T (1986) Gastric cancer in Poland—a decreased malignancy due to changing nutritional habits of the population. Neoplasma 33:97–106

    CAS  Google Scholar 

  3. 3.

    Jedrychowski W, Popiela T, Steindorf K, Tobiasz-Adamczyk B, Kulig J, Penar A, Wahrendorf J (2001) Nutrient intake patterns in gastric and colorectal cancers. Int J Occup Med Environ Health 14:391–395

    CAS  Google Scholar 

  4. 4.

    Venturi S, Venturi A, Cimini D, Arduini C, Venturi M, Guidi A (1993) A new hypothesis: iodine and gastric cancer. Eur J Cancer Prev 2:17–23

    Article  CAS  Google Scholar 

  5. 5.

    Venturi S, Donati FM, Venturi A, Venturi M, Grossi L, Guidi A (2000) Role of iodine in evolution and carcinogenesis of thyroid, breast and stomach. Adv Clin Path 4:11–17

    CAS  Google Scholar 

  6. 6.

    Venturi S, Grossi L, Marra GA, Venturi A, Venturi M (2003) Iodine, Helicobacter pylori, stomach cancer and evolution. Eur Epimarker 7:1–7

    Google Scholar 

  7. 7.

    Tramontano D, Veneziani BM, Lombardi A (1989) Iodine inhibits the proliferation of rat thyroid cells in culture. Endocrinology 125:984–992

    CAS  Article  Google Scholar 

  8. 8.

    Gulaboglu M, Yildiz L, Celebi F, Gul M, Peker K 2005 Comparision of iodine contents in gastric cancer and surrounding normal tissues. Clin Chem Lab Med 43:581–584

    Article  CAS  Google Scholar 

  9. 9.

    Behrouzian R, Aghdami N (2004) Urinary iodine/creatinine ratio in patients with stomach cancer in Urmia, Islamic Republic of Iran. East Mediterr Health J 10:921–924

    CAS  Google Scholar 

  10. 10.

    Szybinski Z, Delange F, Lewiński A, Podoba J, Rybakowa M, Wasik R, Szewczyk L, Huszno B, Golkowski F, Przybylik-Mazurek E, Karbownik M, Zak T, Pantoflinski J, Trofimiuk M, Kinalska I (2001) A programme of iodine supplementation using only iodised household salt is efficient—the case of Poland. Eur J Endocrinol 144:331–333

    Article  CAS  Google Scholar 

  11. 11.

    Golkowski F, Huszno B, Trofimiuk M, Sowinski J, Bandurska-Stankiewicz E, Dorant B, Szybinski Z (2003) Prevalence of goiter in schoolchildren—a study on the influence of adequate iodine prophylaxis. J Endocrinol Invest 26(Suppl. to No. 2):11–15

    CAS  Google Scholar 

  12. 12.

    Szybinski Z, Lewinski A (1998) National Programme for Elimination of Iodine Deficiency Disorders in Poland (1999–2003). Endokrynol Pol 49:203–213

    Google Scholar 

  13. 13.

    Sandell EB, Kolthoff JM (1934) Catalytic method for determination of microquantities of iodine. J Am Chem Soc 56:1426–1442

    Article  CAS  Google Scholar 

  14. 14.

    Rachtan J, Geleta M, Sokolowski A, et al. (2003) Epidemiology of gastric cancer. In: Epidemiology of the malignant neoplasms in Kraków’s region (1985–1999). Oncologic Center in Kraków

  15. 15.

    Delange F, Benker G, Caron PH, Eber O, Ott W, Peter F, Podoba J, Simescu M, Szybinski Z, Vertongen F, Vitti P, Wiersinga W, Zamrazil V (1997) Thyroid volume and urinary iodine in European schoolchildren: standardization of values for assessment of iodine deficiency. Eur J Endocrinol 136:180–187

    CAS  Google Scholar 

  16. 16.

    Szybinski Z (1998) Results of the programme on iodine deficiency in Poland and monitoring system of mandatory model of iodine prophylaxis. Endokrynol Pol 49:9–20

    Google Scholar 

  17. 17.

    Szybinski Z, Zarnecki A (1993) Prevalence of goitre, iodine deficiency and iodine prophylaxis in Poland. The results of nation-wide study. Endokrynol Pol 44:373–388

    CAS  Google Scholar 

  18. 18.

    Huszno B, Hubalewska-Hola A, Baldys-Waligorska A, Sowa-Staszczak A, Szybinski Z (2003) The impact of iodine prophylaxis on thyroid 131-iodine uptake in the region of Kraków, Poland. J Endocrinol Invest 26(Suppl. to No. 2):7–10

    CAS  Google Scholar 

  19. 19.

    ICCIDD (2003) Iodine deficiency in Europe. J Endocrinol Invest 26(Suppl. to No. 9):60–62

    Google Scholar 

  20. 20.

    Spitzweg C, Joba W, Eisenmenger W, Heufelder AE (1998) Analysis of human sodium iodide gene symporter expression in extrathyroid tissue and cloning of its complementary deoxyribonucleic acid from salivary gland, mammary gland and gastric mucosa. J Clin Endocrinol Metab 83:1746–1751

    Article  CAS  Google Scholar 

  21. 21.

    Banerjee RK, Bose AK, Chakraborty TK, De SK, Datta AG (1985) Peroxidase-catalysed iodotyrosine formation in dispersed cells of mouse extrathyroidal tissues. J Endocrinol 106:159–165

    CAS  Article  Google Scholar 

  22. 22.

    Wojtyniak B, Gorynski P, Kuszewski K (2003). Malignant neoplasms. In: Health status of the polish population. National Institute of Hygiene, Warsaw, pp 103–109

  23. 23.

    Jedrychowski W, Maugeri U (2004) Contribution of epidemiology in Poland to better understanding of the natural history of gastrointestinal tract diseases. Eur Epimarker 8:1–7

    Google Scholar 

  24. 24.

    Sekula W, Figurska K, Jutrowska I, Barysz A (2004) Dlugookresowe zmiany w spozyciu zywnosci w Polsce i ich skutki zywieniowe i zdrowotne. Zyw Czlow Metab Supl 2:55–72

    Google Scholar 

  25. 25.

    Bielanski W (1999) Epidemiological study on Helicobacter pylori infection and extragastroduodenal disorders in Polish population. J Physiol Pharmacol 50:723–733

    CAS  Google Scholar 

  26. 26.

    Celinski K, Kurzeja-Miroslaw A, Slomka M, Cichoz-Lach H, Madro A, Kasztelan-Szczerbinska B (2006) Ann Agric Environ Med 13:185–191

    Google Scholar 

  27. 27.

    Abnet CC, Fan JH, Kamangar F, Sun XD, Taylor PR, Ren JS, Mark SD, Zhao P, Fraumeni JF Jr, Qiao YL, Dawsey SM (2006) Self-reported goiter is associated with a significantly increased risk of gastric noncardia adenocarcinoma in a large population-based Chinese cohort. Int J Cancer 119:1508–1510

    Article  CAS  Google Scholar 

  28. 28.

    Kandemir EG, Yonem A, Narin Y (2005) Gastric carcinoma and thyroid status. J Inter Med Res 33:222–227

    CAS  Google Scholar 

  29. 29.

    Kamangar F, Dawsey SM, Blaser MJ, Perez-Perez GI, Pietinen P, Newschaffer CJ, Abnet CC, Albanes D, Virtamo J, Taylor PR (2006) Opposing risks of gastric cardia and noncardia gastric adenocarcinomas associated with Helicobacter pylori seropositivity. J Nat Cancer Inst 98:1445–1452

    Article  Google Scholar 

  30. 30.

    Comment of Nyren O, Blot WJ (2006). J Nat Cancer Inst. 98:1432–1434

  31. 31.

    WHO, UNICEF, ICCIDD (2001) Assessment of the iodine deficiency disorders and monitoring their elimination. WHO, Geneva

    Google Scholar 

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Correspondence to Filip Gołkowski MD, PhD.

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Gołkowski, F., Szybiński, Z., Rachtan, J. et al. Iodine prophylaxis—the protective factor against stomach cancer in iodine deficient areas. Eur J Nutr 46, 251–256 (2007).

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  • gastric cancer
  • iodine deficiency
  • iodine prophylaxis