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The cancers most frequently associated with elevated B12 include: Haematological malignancies: Acute and chronic myeloid leukaemia, polycythaemia vera, and certain lymphomas may increase B12 through abnormal production of B12-binding proteins or release from malignant cells Liver cancers: Hepatocellular carcinoma and metastatic liver disease can cause B12 release from damaged hepatocytes, as the liver stores a majority (approximately 50-60%) of the body's B12 reserves Solid tumours: Various solid organ cancers, particularly those with liver involvement, have been reported in association with elevated B12, though the mechanisms are less well understood The proposed mechanisms linking cancer to elevated B12 include increased production of haptocorrin (a B12-binding protein) by tumour cells, release of B12 from necrotic tumour tissue, and impaired cellular B12 uptake