Dr. Peter D'Adamo / Cancer and ABO Blood Group

PETER J. D'ADAMO, ND
Reviewed and revised on: 02/12/2019

BLOOD TYPE AND CANCER

Although there are probably over a thousand publications on the associations of blood groups and disease, many are based totally on statistical analyses. Most of the earlier studies have been controversial, because they were small studies and/or had inadequate controls and/or had been analyzed incorrectly.

Nevertheless, it is difficult to argue with the general pattern that emerges from the large body of statistical data on malignancy, coagulation and infection. Some of the findings on microbe receptors, and the association with important immune proteins are most convincing and suggest that blood group antigens do play an important biological role: A role that is often completely unrelated to the red blood cell.

It can be said at the outset, that cancers in general tend to be associated with group A, and slightly less strongly with group B. With that, let's look at some trends among selected cancers with regard to blood type.

BREAST CANCER 

Breast cancer is the most common cancer among women. And while the mortality rates are falling slightly for some sub-populations of women, it is still a potentially lethal adversary.

Standard treatment can vary but procedures such as lumpectomy surgery (removal of the tumor and some surrounding tissue), mastectomy (removal of the whole breast), chemotherapy, radiation, and hormone-blocking therapy are the norm with any combination of the above strategies potentially employed.

- Roots I, Drakoulis N, Ploch M, et al. Debrisoquine hydroxylation phenotype, acetylation phenotype, and ABO blood groups as genetic host factors of lung cancer risk. Klin Wochenschr 1988;66 Suppl 11:87-97

Evidence also suggests that loss of blood group A antigen on lung tumor tissue is a strong adverse prognostic marker for patients with resected non-small cell lung cancer (NSCLC). 

- Graziano SL, Tatum AH, Gonchoroff NJ, Newman NB, Kohman LJ. Blood group antigen A and flow cytometric analysis in resected early-stage non-small cell lung cancer. Clin Cancer Res 1997 Jan;3(1):87-93

Mammograms have been a major push within medicine as a means of early detection; however, many of my patients have actually discovered there tumors on self-examination of breast tissue, so I cannot overemphasize this self-help procedure (especially for A's and AB's as we will see).

While many risk factors are associated with the development of breast cancer, it is seldom mentioned that blood type has an influence on susceptibility and outcomes. In fact, some researchers have even gone so far as to say that "blood groups were shown to possess a predictive value independent of other known prognostic factors" when discussing breast cancer.

Other researchers have actually suggested that a degree of the susceptibility to breast cancer, from a gene perspective, might be a result of a breast cancer-susceptibility locus linked to the ABO locus located on band q34 of chromosome 9. 

- Costantini M, Fassio T, Canobbio L, et al. Role of blood groups as prognostic factors in primary breast cancer. Oncology 1990;47(4):308-12 

- Skolnick MH, Thompson EA, Bishop DT, Cannon LA. Possible linkage of a breast cancer-susceptibility locus to the ABO locus: sensitivity of LOD scores to a single new recombinant observation. Genet Epidemiol 1984;1(4):363-73

My observation has been that blood type A women have a generalized tendency to worse outcomes and a more rapid progression with this cancer. Research indicates that blood type A women are over-represented among breast cancer patients, and that this trend occurs even among women thought to be at low risk for cancer.

One of the most significant risk factors for a rapidly progressing breast cancer is also blood type A, and blood type A women have been observed to have poorer outcomes once they are diagnosed with breast cancer.

In complete opposition to these blood type A tendencies, we find blood type O. Blood type O infers a slight degree of resistance against breast cancer, and even among patients, blood type 0 showed a significantly lower risk of death. Type AB's fall nearer to A's, having a slight increase in susceptibility and a more dramatic trend towards recurrence and shorter survival times.

Blood type B generally acts a bit more like blood type O, imparting a degree of reduced susceptibility or reduced risk. This is particularly evident among women who do not have a family history of breast cancer. However, there are two areas to consider if you are a blood type B woman.

If you have had a family member with breast cancer, the protection normally associated with being a B women goes out the window, and you need to be more aware of the possibility of breast cancer. Also, if you are a B women and currently have or have had breast cancer, statistically speaking, your odds of a recurrence of breast cancer tend to be higher.

Part of the reason for this is that you tend to survive the original cancer, but nevertheless, you might want to consider some of the long-term immune building and anti-cancer strategies we will discuss.

- Mourali N, Muenz LR, Tabbane F, et al. Epidemiologic features of rapidly progressing breast cancer in Tunisia. Cancer 1980;46:2741-6 

- Rosen PP, Schwartz MK, Menedez-Botet CJ. Blood groups and response to therapy for mammary cancer. Am J Clin Pathol 1977;67:504-5 [Letter] 

- Anderson DE, Haas C. Blood type A and familial breast cancer. Cancer 1984 Nov 14(9):1845-1849 

- Costantini M, Fassio T, Canobbio L, et al. Role of blood groups as prognostic factors in primary breast cancer. Oncology 1990;47(4):308-12 

- Tryggvadottir L, Tulinius H, Robertson JM. Familial and sporadic breast cancer cases in Iceland: a comparison related to ABO blood groups and risk of bilateral breast cancer. Int J Cancer 1988 Oct 15;42(4):499-501 

- Horn PL, Thompson WD. Risk of contralateral breast cancer. Associations with histological, clinical, and therapeutic factors. Cancer 1988;62:412-24. 

- Holdsworth PJ, Thorogood J, Benson EA, Clayden AD. Blood group as a prognostic indicator in breast cancer. Br Med J (Clin Res Ed) 1985 Mar 2;290(6469):671-3

Breast cancer shows a weaker association with being a non-secretor.

FEMALE REPRODUCTIVE CANCERS (GYNECOLOGICAL TUMORS) 

As a general rule, gynecological tumors occur more frequently and are associated with worse prognosis in blood type A women. As examples, endometrial cancer occurs more frequently in Type A, ovarian cancer occurs more frequently in A's and AB's. For both of these cancers blood type A is associated with worse 5- and 10-year survival.

Conversely, the best survival rate is seen among blood type O women, followed by B women. Type B women are also the least likely to have an ovarian tumor that is malignant. With regard to cervical cancer, analysis also shows a strong trend towards higher frequency of cancer and poor outcomes among A women, a slight trend towards increased risk for B's, and a better 5-year survival among 0 blood phenotype.

- Marinaccio M, Traversa A, Carioggia E, et al. Blood groups of the ABO system and survival rate in gynecologic tumors. Minerva Ginecol 1995 Mar;47(3):69-76 

- Bjarnason O, Tulinius H. Tumours in Iceland. 9. Malignant tumours of the ovary. A histological classification, epidemiological considerations and survival. Acta Pathol Microbiol Immunol Scand [A] 1987 Jul;95(4):185-192 

- Nayak SK. ABO blood groups in different diseases. J. Ind Med 19971;87:449-52 

- Rybalka AN, Andreeva PV, Tikhonenko LF, Koval'chuk NA. ABO system blood groups and the rhesus factor in tumors and tumorlike processes of the ovaries. Vopr Onkol 1979;25(3):28-30 [Article in Russian] 

- Mori M, Kiyosawa H, Miyake H. Case-control study of ovarian cancer in Japan. Cancer 1984 Jun 15;53(12):2746-52 

- Langer M, Gitsch E, Salzer H. Significance of ovulatory age in the pathogenesis of ovarian cancer. Geburtshilfe Frauenheilkd 1984 Jun;44(6):366-7 

- Kaur I, Singh IP, Bhasin MK. Blood groups in relation to carcinoma of cervix uteri. Hum Hered 1992;42(5):324-6

Key point:

* Type O associated with better 5-year survival for cervical cancer.

* Type O associated with better 5- and 10-year survival for endometrial cancer.

* Type O and B associated with better 5-year survival for ovarian cancer.

Similar to other cancers we will mention, ovarian cancer is characterized by a loss of blood type antigens. Uterine endometrial cancers often have an opposite presentation.

Normal endometrial tissue does not contain ABO antigens; however, over of endometrial cancers have detectable A, B or H antigens. An increased rate of expression of Lewis group antigens, particularly Lewis(b) antigen, is also observed in endometrial cancers compared with its expression in normal endometria. 

- Metoki R, Kakudo K, Tsuji Y, et al. Deletion of histo-blood group A and B antigens and expression of incompatible A antigen in ovarian cancer. J Natl Cancer Inst 1989 Aug 2;81(15):1151-7 

- Tsukazaki K, Sakayori M, Arai H, et al. Abnormal expression of blood group-related antigens in uterine endometrial cancers. Jpn J Cancer Res 1991 Aug;82(8):934-41

BLADDER CANCER 

Bladder cancer appears to be an exception to the generalized observation of A's and cancer aggressiveness. In a study by Llopis et al, the researchers noticed that blood group O had a tendency to increased aggressiveness, higher tumor grade, and more relapses. Surprisingly, blood type A individuals generally were less likely to have aggressive cancer and were somewhat protected against relapses of bladder cancer.

Srinivas et al observed a similar trend. They found that among 141 patients with bladder cancer, individuals with blood group A had lower grade tumors and lower mortality rates. Blood type O's generally had higher grade tumors and higher mortality rates.

Other researchers have also observed similar trends, such as the blood type O tendency to higher grade tumors, larger tumors, progression to advanced disease, and increased rates of mortality (especially after 8 years). 

- Llopis B, Ruiz JL, Server G, et al. ABO blood groups and bladder carcinoma. Eur Urol 1990;17(4):289-92 

- Srinivas V, Khan SA, Hoisington S, Varma A, Gonder MJ. Relationship of blood groups and bladder cancer. J Urol 1986 Jan;135(1):50-2 

- Orihuela E, Shahon RS. Influence of blood group type on the natural history of superficial bladder cancer. J Urol 1987 Oct;138(4):758-9 

- Raitanen MP, Tammela TL. Relationship between blood groups and tumour grade, number, size, stage, recurrence and survival in patients with transitional cell carcinoma of the bladder. Scand J Urol Nephrol 1993;27(3):343-7

Similar to most cancers, bladder cancer is characterized by a dissappearance ofnormal ABO antigen expression and an appearance of specialized adherence molecules. 

- Orlow I, Lacombe L, Pellicer I, et al. Genotypic and phenotypic characterization of the histoblood group ABO(H) in primary bladder tumors. Int J Cancer 1998 Mar 16;75(6):819-24 

- Orntoft TF, Wolf H. Molecular alterations in bladder cancer. Urol Res 1998;26(4):223-33

Key Point:

Blood Type O is associated with higher grade, larger, more aggressive bladder cancer. They tend to have the greatest tendency to advanced disease, more relapses, and higher mortality rates.

Blood type A is actually protective for this type of cancer. Blood type AB inherits the A tendency for protection, while blood type B's fall closer to O with regard to this cancer.

LUNG CANCER 

Lung Cancer is and has been one of the leading causes of cancer deaths in the U.S. It is expected that about 180,000 new cases will be diagnosed within the U.S. this year, and of these, about 160,000 people will die. While the incidence of lung cancer has been declining in men since the 1980s, it is still rising in women.

The most well known risk factor for lung cancer is cigarette smoking (which has been linked to 85 to 90 percent of all cases). Other well known risk factors include exposure in the workplace to certain substances (including asbestos and some organic chemicals), radiation exposure, radon exposure (especially in smokers), and even second-hand environmental tobacco smoke.

Because of the close associated of lung cancer with cigarette smoking, we would expect this strong risk factor to possibly overwhelm any blood type differences.

However, we still see a higher number of A's and a lower number of O's with lung cancer. This trend is even greater among individuals younger than 50 (where it is especially high).

This suggests that smoking, which increases risk for lung cancer with each decade of exposure, somewhat mutes the blood type connection in a population which has had many decades of smoking history, but still cannot camoflage the blood type A connection to lung cancer.