Circulating C-reactive protein and colorectal cancer risk: a report from the Shanghai Men's Health Study

Abstract

Chronic inflammation has been implicated in the pathogenesis of colorectal cancer. The objective of this study was to evaluate the association of prediagnostic circulating levels of C-reactive protein (CRP), a biomarker of systemic inflammation, with subsequent development of colorectal cancer. Prediagnostic plasma CRP levels were examined among 288 colorectal cancer cases and 576 individually-matched controls nested within the Shanghai Men's Health Study (2002-06), a population-based cohort study of 61 482 Chinese men. The association between CRP levels and colorectal cancer risk was investigated. Baseline plasma CRP levels were 53% higher among men who subsequently developed colorectal cancer than among those who remained free of the disease (1.15 versus 0.75 μg/ml; P < 0.001). Multivariate analyses showed a dose-dependent relationship between CRP and colorectal cancer risk (P trend = 0.003); men in the highest tertile (CRP > 1.19 μg/ml) had 1.88-fold (95% confidence interval (CI): 1.24-2.86) increased odds of developing colorectal cancer compared with men in the lowest tertile (CRP < 0.45 μg/ml). The association was only significant for colon cancer, when cancer site was considered, and was predominantly seen for cases diagnosed within 4 years of blood collection; adjusted odds ratios for the highest versus the lowest tertiles were 3.28 (95% CI: 1.28-8.37), 3.68 (95% CI: 1.62-8.38) and 1.05 (95% CI: 0.56-1.97), respectively, for cases diagnosed <2, 2-4 and >4 years after blood collection. The findings from our study suggest that circulating CRP level is positively associated with colorectal cancer risk in Chinese men, and this association, at least in part, is explained by inflammation-related cancerous or precancerous processes.

Dietary inflammatory index and inflammatory gene interactions in relation to colorectal cancer risk in the Bellvitge colorectal cancer case–control study

“…In other epidemiological studies, similar associations were reported for colon and rectal cancer risks with DII score (Shivappa et al 2014a), and intakes of fruits and vegetables, fiber, and flavonoids (World Research Cancer Fund and American Institute for Cancer Research 2007; Zamora- Ros et al 2013b;Murphy et al 2012). However, for circulating CRP levels, significant associations were observed only for colon cancer risk (Aleksandrova et al 2010;Wu et al 2013). Although colon and rectal cancers may have different etiologies (Wei et al 2004), our study did not show large differences between colon and rectal cancer in the effect of inflammation.…”

The association between dietary inflammatory index and risk of colorectal cancer among postmenopausal women: results from the Women’s Health Initiative

“…The link between inflammation and colon cancer is further supported by evidence from studies showing a positive association between higher concentrations of inflammatory biomarkers and increased risk of colon cancer (49–51); or a reduced risk of colon cancer with regular use of NSAIDs (7–9). A pro-inflammatory diet also may be linked to increased colon cancer risk through some component of the metabolic syndrome, especially insulin resistance or glucose intolerance (52, 53).…”

Polymorphisms in the CHIT1 gene: Associations with colorectal cancer

“…However, in some cases the inflammatory responses may transform into chronic inflammations [27] or facilitate carcinogenesis [26, 28, 29]. Several inflammatory biomarkers, such as C-reactive protein, have been reported in the colorectal cancers process [30]. In this work, we characterized two variations rs61745299 and rs35920428 within the CHIT1 gene that were associated with elevated expression levels of the C-reaction protein in the cancer tissue.…”