Research Papers:

Circulating uric acid levels and subsequent development of cancer in 493,281 individuals: findings from the AMORIS Study

Andrew Yiu, Mieke Van Hemelrijck, Hans Garmo, Lars Holmberg, Håkan Malmström, Mats Lambe, Niklas Hammar, Göran Walldius, Ingmar Jungner and Wahyu Wulaningsih _

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Oncotarget. 2017; 8:42332-42342. https://doi.org/10.18632/oncotarget.16198

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Andrew Yiu1, Mieke Van Hemelrijck1,4, Hans Garmo1,2, Lars Holmberg1,2,3, Håkan Malmström4, Mats Lambe3,5, Niklas Hammar4,6, Göran Walldius7, Ingmar Jungner8 and Wahyu Wulaningsih1

1King’s College London, Division of Cancer Studies, Cancer Epidemiology Group, London, UK

2Regional Cancer Centre, Uppsala, Sweden

3Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden

4Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

5Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

6AstraZeneca R&D, Mölndal, Sweden

7Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

8Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet and CALAB Research, Stockholm, Sweden

Correspondence to:

Wahyu Wulaningsih, email: [email protected]

Keywords: uric acid, cancer, prospective study

Received: November 01, 2016    Accepted: February 06, 2017    Published: March 15, 2017


Objectives: Serum uric acid has been suggested to be associated with cancer risk. We aimed to study the association between serum uric acid and cancer incidence in a large Swedish cohort.

Results: A positive association was found between uric acid levels and overall cancer risk, and results were similar with adjustment for glucose, triglycerides and BMI. Hazard ratio (HR) for overall cancer for the 4th quartile of uric acid compared to the 1st was 1.08 (95% CI: 1.05–1.11) in men and 1.12 (1.09 – 1.16) in women. Site-specific analysis showed a positive association between uric acid and risk of colorectal, hepatobiliary, kidney, non-melanoma skin, and other cancers in men and of head and neck and other cancers in women. An inverse association was observed for pulmonary and central nervous system (CNS) cancers in men and breast, lymphatic and haematological, and CNS malignancies in women.

Materials and Methods: We included 493,281 persons aged 20 years and older who had a measurement of serum uric acid and were cancer-free at baseline in the AMORIS study. Multivariable Cox proportional hazards regression was used to investigate sex-specific quartiles of serum uric acid in relation to cancer risk in men and women. Analysis was further adjusted for serum glucose, triglycerides and, where available, BMI. Site-specific analysis was performed for major cancers.

Conclusions: Altered uric acid levels were associated with risk of overall and some specific cancers, further indicating the potential role of uric acid metabolism in carcinogenesis.

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