Inflammatory biomarkers, aspirin, and risk of colorectal cancer: Findings from the physicians’ health study

Abstract

Background Chronic inflammation has been implicated in colorectal carcinogenesis. However, the associations between plasma inflammatory markers and risk of colorectal cancer have been inconsistent. Methods In a nested case-control study in the Physicians’ Health Study, we prospectively investigated the associations of plasma C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor receptor 2 (TNFR-2) with risk of colorectal cancer, and whether aspirin modified these associations among 268 colorectal cancer patients and 446 age- and smoking-matched controls. Results In multivariate-adjusted models, plasma levels of CRP, IL-6 and TNFR-2 were not significantly associated with risk of colorectal cancer, although a positive trend was observed for TNFR-2 (RRhighest vs. lowest quartile=1.55; 95% CI=0.95–2.54; Ptrend=0.05). We observed a statistically significant association between elevated TNFR-2 levels and colorectal cancer risk in the placebo arm (RRhighest vs. lowest tertile=1.77; 95% CI=1.02–3.06; Ptrend=0.02), but not in the aspirin arm (Ptrend=0.72). However, the interaction between TNFR-2 and aspirin was not statistically significant (Pinteraction=0.34). Conclusion Plasma inflammatory markers were not significantly associated with colorectal cancer risk among men, though there was a statistically non-significant positive trend between TNFR-2 and colorectal cancer risk. More studies are required to understand the relationship between the role of TNFα pathway, aspirin, and colorectal cancer risk.

Chronic inflammation towards cancer incidence: A systematic review and meta-analysis of epidemiological studies

“…No association was seen in the meta-analysis between fibrinogen and CRC risk (409 cases, Figure 2f), but a positive association has been reported in two prospective studies that used HR as risk measure [76,94]. Only one [32] out of six [28,32,34,51,74, 87] studies (some using HR while others OR) on IL-6 and CRC reported a positive association with OR=1.76 (95%CI 1.01-3.06). All other inflammatory parameters were examined in less than 4 studies.…”

Diagnostic value of plasma M2-pyruvate kinase in Egyptian patients with colorectal cancer

“…Their study showed that plasma inflammatory indicators, which include CRP, have not been significantly linked to CRC risk in men and that the null relationship between plasma CRP level and CRC risk noted in this research is consistent with the majority of prior research by. 18 In contrast, in 19 of their studies, they found that CRP levels are increased in those with CRC and that inflammation is a risk factor for the progression of colon cancer in people at average risk.…”