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Association of inflammatory markers with colorectal cancer incidence in the atherosclerosis risk in communities study.

TitleAssociation of inflammatory markers with colorectal cancer incidence in the atherosclerosis risk in communities study.
Publication TypeJournal Article
Year of Publication2011
AuthorsPrizment AE, Anderson KE, Visvanathan K, Folsom AR
JournalCancer Epidemiol Biomarkers Prev
Volume20
Issue2
Pagination297-307
Date Published2011 Feb
ISSN1538-7755
KeywordsAcute-Phase Proteins, Aged, Atherosclerosis, Biomarkers, C-Reactive Protein, Cohort Studies, Colorectal Neoplasms, Factor VIII, Female, Fibrinogen, Follow-Up Studies, Humans, Incidence, Inflammation, Leukocyte Count, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Survival Rate, von Willebrand Factor
Abstract

BACKGROUND: Chronic inflammation has been implicated in the etiology of colorectal cancer (CRC), but epidemiologic findings on the association between circulating inflammatory markers and CRC risk are inconsistent. We hypothesized that increased concentrations of systemic inflammatory markers-white blood cell count (WBC), fibrinogen, von Willebrand factor (VWF), factor VIII (FVIII), and C-reactive protein (CRP)-and decreased albumin concentration would be associated with increased CRC risk in the Atherosclerosis Risk in Communities prospective cohort.

METHODS: WBC, fibrinogen, VWF, FVIII, and albumin, measured in 1987-1989 in 13,414 men and women, were transformed to z-scores and summed up to construct a blood "inflammation z-score." Albumin was included with a negative sign, because its concentration decreases with greater inflammation. A total of 308 incident CRC cases were identified through 2006 in initially cancer-free participants. CRP was measured in 1996-1998 in 9,836 cancer-free people who developed 166 CRCs through 2006. Proportional hazard models were used to estimate the HR and 95% CI of CRC in relation to each individual marker and the inflammation z-score.

RESULTS: After multivariate adjustment, for the highest versus lowest quartile, there was a statistically significant positive association of CRC risk with fibrinogen: HR = 1.50 (95% CI, 1.05-2.15), P = 0.03; inflammation z-score: HR = 1.65 (95% CI, 1.15-2.35), P = 0.01; and CRP: HR = 1.97 (95% CI, 1.13-3.43, P = 0.02.

CONCLUSIONS: These findings indicate that greater levels of fibrinogen, CRP, and blood inflammation z-score are associated with increased CRC risk.

IMPACT: The study provides further evidence that precancer inflammation may contribute to CRC etiology.

DOI10.1158/1055-9965.EPI-10-1146
Alternate JournalCancer Epidemiol Biomarkers Prev
PubMed ID21217085
PubMed Central IDPMC3169294
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
N01 HC055019 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
1 R01 DK076770-01 / DK / NIDDK NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
R01 DK076770 / DK / NIDDK NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States