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In humans, expression of iron transport proteins are altered in colorectal cancer. This study examined whether the route of iron therapy alters iron transport and tumour growth. Colorectal adenocarcinoma patients with pre-operative iron deficiency anaemia received oral ferrous sulphate (n\u2009=\u200915), or intravenous ferric carboxymaltose (n\u2009=\u200915). Paired (normal and tumour tissues) samples were compared for expression of iron loading, iron transporters, proliferation, apoptosis and Wnt signalling using immunohistochemistry and RT-PCR. Iron loading was increased in tumour and distributed to the stroma in intravenous treatment and to the epithelium in oral treatment. Protein and mRNA expression of proliferation and iron transporters were increased in tumours compared to normal tissues but there were no significant differences between the treatment groups. However, intravenous iron treatment reduced ferritin mRNA levels in tumours and replenished body iron stores. Iron distribution to non-epithelial cells in intravenous iron suggests that iron is less bioavailable to tumour cells. Therefore, intravenous iron may be a better option in the treatment of colorectal cancer patients with iron deficiency anaemia due to its efficiency in replenishing iron levels while its effect on proliferation and iron metabolism is similar to that of oral iron treatment.<\/jats:p>","DOI":"10.1038\/s41598-021-93155-2","type":"journal-article","created":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T10:02:45Z","timestamp":1625133765000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Intravenous iron is non-inferior to oral iron regarding cell growth and iron metabolism in colorectal cancer associated with iron-deficiency anaemia"],"prefix":"10.1038","volume":"11","author":[{"given":"Hafid O.","family":"Al-Hassi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Ng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rayko","family":"Evstatiev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manel","family":"Mangalika","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Worton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Jambrich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vineeta","family":"Khare","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Phipps","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barrie","family":"Keeler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Gasche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Austin G.","family":"Acheson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Brookes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,7,1]]},"reference":[{"key":"93155_CR1","first-page":"164","volume":"19","author":"NR Abbaspour","year":"2014","unstructured":"Abbaspour, N. 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MJB research department has received grant support from Tillotts Pharma and Vifor Pharma (Switzerland). MJB has received honoraria and travel support for consulting or lecturing from Vifor Pharma, Tillotts Pharma and Abbvie. AA research department has received grant support from Pharmacosmos, Denmark and Vifor Pharma, Switzerland. Honoraria or travel support received for lecturing from the following companies: Olympus, Essex, UK., Vifor Pharma Ltd, Switzerland and Pharmacosmos, Denmark. CG: Advisory Board\/Consultant\/Speaker\u2019s Bureau: Fresenius Medical Care, Pharmacosmos A\/S, Renapharma Sweden, Vifor Int.; Grant\/Research Support: AOP Orphan Pharmaceuticals, Biogena Naturstoffe GmbH. RE: Advisory Board for AOP Orphan Pharmaceuticals, Speaker\u2019s honoraries from Vifor Pharma Int and AOP Orphan Pharmaceuticals.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"13699"}}