Ferritin is a protein inside cells that stores iron in a safe, non-toxic form, making it available for essential biological processes like oxygen transport and immune function. It also acts as an acute phase reactant, meaning its levels can rise significantly during inflammation, infection, or other systemic stress. Understanding this dual role as an iron-storage protein and an inflammation marker is important for interpreting its levels.
Common Causes of High Ferritin
Elevated ferritin levels do not automatically indicate cancer, as numerous non-cancerous conditions can also lead to an increase. Inflammation is a common cause, with ferritin rising during acute or chronic infections, as well as autoimmune disorders like rheumatoid arthritis. In these situations, ferritin increases as part of the body’s generalized immune response.
Liver diseases frequently cause high ferritin because the liver is a primary site for iron storage and production. Conditions like viral hepatitis, alcoholic liver disease, and non-alcoholic fatty liver disease (NAFLD/NASH) can elevate ferritin due to liver cell damage or inflammation. Iron overload conditions, such as hereditary hemochromatosis, also significantly increase ferritin as the body stores excess iron, directly reflecting accumulated stores.
Specific Cancers Linked to Elevated Ferritin
Certain cancers can cause ferritin levels to rise, making it a potential, though non-specific, indicator. Hematologic malignancies, which are cancers of the blood, bone marrow, and lymph nodes, are known for significant ferritin elevation. These include leukemias like acute myeloid leukemia (AML), where high levels are often seen at diagnosis and can decrease with remission. Myelodysplastic syndromes (MDS) also commonly present with elevated ferritin, sometimes due to altered iron metabolism. Lymphomas, including Hodgkin’s and non-Hodgkin’s, are also associated with increased ferritin.
Solid tumors can also lead to elevated ferritin, often reflecting the body’s systemic response to the cancer. Hepatocellular carcinoma, a liver cancer, commonly presents with high ferritin, which can correlate with disease progression and poor survival. Renal cell carcinoma, a kidney cancer, frequently shows increased ferritin, with levels rising with advancing stages and decreasing after tumor removal. Breast cancer patients often exhibit higher ferritin, linked to disease progression and potentially serving as a prognostic factor.
Other solid tumors, such as lung cancer, colorectal cancer, gastric cancer, and pancreatic cancer, are also associated with elevated ferritin. Mechanisms vary but often involve the body’s inflammatory response to the tumor. Cancer cells themselves can sometimes directly produce ferritin, or the protein may be released from damaged cells during tumor breakdown. Immune cells like tumor-associated macrophages, which infiltrate many cancers, can also contribute by releasing ferritin into the surrounding tissue.
Interpreting High Ferritin in Cancer Screening
When evaluating elevated ferritin levels, it is important to understand that ferritin is not a specific diagnostic tool for cancer. While high ferritin can be present in various malignancies, it is far more commonly elevated due to non-cancerous conditions like inflammation, infection, or liver disease. Therefore, a high ferritin result alone cannot diagnose cancer and requires careful interpretation within the broader clinical picture.
Ferritin levels are considered non-specific because many different processes can cause their increase. An elevated ferritin level serves more as a marker of inflammation or disease activity rather than a direct indicator of a cancerous tumor. Healthcare providers use ferritin alongside other diagnostic tests, such as blood work, imaging studies, and biopsies, to determine the true cause. Relying solely on ferritin for cancer screening or diagnosis would lead to many false positives and is not recommended.
What to Do About High Ferritin
If you receive a blood test result indicating high ferritin levels, consult a healthcare professional. Self-diagnosis should be avoided, as only a thorough medical evaluation can pinpoint the underlying cause.
Further investigation may involve a range of tests to determine why ferritin is elevated. These often include blood tests like a complete blood count, liver function tests, and iron-related studies such as transferrin saturation. Depending on initial findings, imaging studies or genetic testing may be ordered. The treatment plan will focus on addressing the specific condition causing the elevated ferritin, rather than just the ferritin level itself.