Dietary Manganese Intake and Risk of Liver Cancer in Japanese Men and Women: The JACC Study

We explored the association between dietary manganese intake and the risk of liver cancer in 14,517 men and 21,583 women who participated in the Japan Collaborative Cohort Study for Cancer Risk Assessment. We assessed dietary manganese intake using a food frequency questionnaire and incident liver cancer by reviewing cancer registries. According to manganese intake, we estimated the liver cancer risk by Cox regression analyses. During the 513,657 person-year follow-ups within a median of 17.9 years of 36,100 participants, there were 239 incident cases of liver cancer. The multivariable hazard ratio (HR) (95% confidence interval [CI]; P-trend) for liver cancer risk in the highest vs. the lowest quintiles of dietary manganese intake was 0.56 (0.32-0.99; 0.04) in men and 1.16 (0.56-2.40; 0.79) in women; P-interaction = 0.06. The history of liver disease modified the observed association in men (P-interaction = 0.02), in which the multivariable HR (95%CI) of liver cancer risk comparing the highest vs. lowest quintiles of dietary manganese intake was 0.32 (0.14-0.74) in Japanese men without a history of liver disease, while it was 1.54 (0.62-3.79) in men with a history of liver disease. In conclusion, a higher dietary manganese intake was associated with a lower risk of liver cancer in men without a history of liver disease.