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Prospective study of serum cysteine levels and oesophageal and gastric cancers in China
  1. Gwen Murphy1,
  2. Jin-Hu Fan2,
  3. Steven D Mark3,
  4. Sanford M Dawsey1,
  5. Jacob Selhub4,
  6. Jianbing Wang2,
  7. Philip R Taylor1,
  8. You-Lin Qiao2,
  9. Christian C Abnet1
  1. 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
  2. 2Department of Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
  3. 3Biostatistics & Informatics, University of Colorado, Denver, Colorado, USA
  4. 4Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Ageing at Tufts University, Boston, Massachusetts, USA
  1. Correspondence to Dr Gwen Murphy, Nutritional Epidemiology Branch, DCEG, National Cancer Institute, 6120 Executive Blvd., EPS 3034, Rockville, MD 20892, USA; murphygw{at}
  2. Prof You-Lin Qiao, Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, P.O. Box 2258, Beijing 100021, People's Republic of China; qiaoy{at}


Background Cancers of the upper gastrointestinal tract remain a significant cause of morbidity and mortality. Cysteine, known to be involved in a myriad of immuno-modulatory, anti-oxidant, and anti-carcinogenic pathways, has not been investigated in the aetiology of oesophageal or gastric cancers. To examine the relationship between serum cysteine concentration and risk of these cancers we conducted a nested case–cohort study within the General Population Nutrition Intervention Trial in Linxian, China.

Methods 498 oesophageal squamous cell carcinomas (OSCCs) and 255 gastric cardia adenocarcinomas (GCAs) were matched by age and sex to 947 individuals from the wider cohort. We calculated HRs and 95% CIs using the case–cohort estimator for the Cox proportional hazards models, stratified on age and sex, with adjustment for potential confounders.

Results Higher concentrations of serum cysteine were significantly associated with a lower risk of both OSCC and GCA. For those in the highest quartile of serum cysteine, compared to those in the lowest, the multivariate HRs were 0.70 for OSCC (95% CI 0.51 to 0.98) and 0.59 for GCA (95% CI 0.38 to 0.91). These associations were dose dependent (p for trend=0.006 and 0.008, respectively). These inverse associations were not significantly modified by other risk factors, with the exception of age, where a stronger association was noted among persons in the older age strata.

Conclusion Higher serum concentrations of cysteine were associated with a significantly reduced risk of OSCC and GCA. Cysteine should be further investigated for its potential as a chemopreventive agent for upper gastrointestinal cancers.

  • Oesophageal squamous cell carcinoma
  • gastric cardia cancer
  • HR
  • cysteine
  • epidemiology
  • gastric cancer
  • oesophageal cancer
  • vitamins

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  • Funding This work was supported by the Intramural Research Program, Division of Cancer Epidemiology and Genetics, the National Cancer Institute, at the National Institutes of Health, Department of Health and Human Services.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the US National Institutes of Health and the Chinese Academy of Medical Sciences.

  • Provenance and peer review Not commissioned; externally peer reviewed.