Cardiovascular disease related circulating biomarkers and cancer incidence and mortality: is there an association?

2021 ◽  
Author(s):  
Manol Jovani ◽  
Elizabeth E Liu ◽  
Samantha M Paniagua ◽  
Emily S Lau ◽  
Shawn X Li ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Cancer Incidence ◽  
Biological Pathways ◽  
Circulating Biomarkers ◽  
Incident Cancer ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
Risk Of Cancer

Abstract Aims Recent studies suggest an association between cardiovascular disease (CVD) and cancer incidence/mortality, but the pathophysiological mechanisms underlying these associations are unclear. We aimed to examine biomarkers previously associated with CVD and study their association with incident cancer and cancer-related death in a prospective cohort study. Methods and Results We used a proteomic platform to measure 71 cardiovascular biomarkers among 5,032 participants in the Framingham Heart Study who were free of cancer at baseline. We used multivariable-adjusted Cox models to examine the association of circulating protein biomarkers with risk of cancer incidence and mortality. To account for multiple testing, we set a 2-sided false discovery rate (FDR Q-value) <0.05. Growth differentiation factor-15 (GDF15; also known as macrophage inhibitory cytokine-1 [MIC1])) was associated with increased risk of incident cancer (hazards ratio [HR] per 1 standard deviation increment 1.31, 95% CI 1.17-1.47), incident gastrointestinal cancer (HR 1.85, 95% CI 1.37-2.50), incident colorectal cancer (HR 1.94, 95% CI 1.29-2.91) and cancer-related death (HR 2.15, 95% CI 1.72-2.70). Stromal cell-derived factor-1 (SFD1) showed an inverse association with cancer-related death (HR 0.75, 95% CI 0.65-0.86). Fibroblast growth factor-23 (FGF23) showed an association with colorectal cancer (HR 1.55, 95% CI 1.20-2.00), and granulin (GRN) was associated with hematologic cancer (HR 1.61, 95% CI 1.30-1.99). Other circulating biomarkers of inflammation, immune activation, metabolism, and fibrosis showed suggestive associations with future cancer diagnosis. Conclusion We observed several significant associations between circulating CVD biomarkers and cancer, supporting the idea that shared biological pathways underlie both diseases. Further investigations of specific mechanisms that lead to both CVD and cancer are warranted. Translational Perspective In our prospective cohort study, baseline levels of biomarkers previously associated with CVD were found to be associated with future development of cancer. In particular, GDF15 was associated with increased risk of cancer incidence and mortality, including gastrointestinal and colorectal cancers; SDF1 was inversely associated with cancer-related death, and FGF23 and GRN were associated with increased risk of colorectal and hematologic cancers, respectively. Other biomarkers of inflammation, immune activation, metabolism, and fibrosis showed suggestive associations. These results suggest potential shared biological pathways that underlie both development of cancer and CVD.

scholarly journals Cancer Incidence in Patients With Acromegaly: A Cohort Study and Meta-Analysis of the Literature

2018 ◽  
Vol 103 (6) ◽  
pp. 2182-2188 ◽  
Author(s):  
Jakob Dal ◽  
Michelle Z Leisner ◽  
Kasper Hermansen ◽  
Dóra Körmendiné Farkas ◽  
Mads Bengtsen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Cohort Study ◽  
Cancer Incidence ◽  
Meta Analysis ◽  
Population Based ◽  
Incidence Rates ◽  
Tract Cancer ◽  
Increased Risk ◽  
Risk Of Cancer

Abstract Context Acromegaly has been associated with increased risk of cancer morbidity and mortality, but research findings remain conflicting and population-based data are scarce. We therefore examined whether patients with acromegaly are at higher risk of cancer. Design A nationwide cohort study (1978 to 2010) including 529 acromegaly cases was performed. Incident cancer diagnoses and mortality were compared with national rates estimating standardized incidence ratios (SIRs). A meta-analysis of cancer SIRs from 23 studies (including the present one) was performed. Results The cohort study identified 81 cases of cancer after exclusion of cases diagnosed within the first year [SIR 1.1; 95% confidence interval (CI), 0.9 to 1.4]. SIRs were 1.4 (95% CI, 0.7 to 2.6) for colorectal cancer, 1.1 (95% CI, 0.5 to 2.1) for breast cancer, and 1.4 (95% CI, 0.6 to 2.6) for prostate cancer. Whereas overall mortality was elevated in acromegaly (SIR 1.3; 95% CI, 1.1 to 1.6), cancer-specific mortality was not. The meta-analysis yielded an SIR of overall cancer of 1.5 (95% CI, 1.2 to 1.8). SIRs were elevated for colorectal cancer, 2.6 (95% CI, 1.7 to 4.0); thyroid cancer, 9.2 (95% CI, 4.2 to 19.9); breast cancer, 1.6 (1.1 to 2.3); gastric cancer, 2.0 (95% CI, 1.4 to 2.9); and urinary tract cancer, 1.5 (95% CI, 1.0 to 2.3). In general, cancer SIR was higher in single-center studies and in studies with <10 cancer cases. Conclusions Cancer incidence rates were slightly elevated in patients with acromegaly in our study, and this finding was supported by the meta-analysis of 23 studies, although it also suggested the presence of selection bias in some earlier studies.

Relationship between alcohol consumption and cancer in rural Chinese adults: 1 5- year follow-up cohort study

2020 ◽  
Author(s):  
Yue Zhang ◽  
Jingyi Li ◽  
Nannan Cheng ◽  
Jie Yang ◽  
Lijing Ye ◽  
...  
Keyword(s):  
Cohort Study ◽  
Alcohol Consumption ◽  
Cancer Incidence ◽  
Rural China ◽  
Density Lipoprotein ◽  
Estimating Equation ◽  
Chinese Adults ◽  
Increased Risk ◽  
Risk Of Cancer

Abstract Background：We aimed to evaluate the association between alcohol consumption and risk of cancer incidence among rural Chinese adults. Methods: We utilized data from a community-based cohort study in rural China enrolled in 2003 and followed up prospectively up to 2018. Generalized estimating equation models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) to analyze the relationship between alcohol consumption and cancer incidence. Results: After an average of 15 years of follow-up, a total of 9870 adult participants were included in this study. The results of the regression analysis for males showed that former drinkers had a significantly increased risk of cancer compared to never drinkers ([OR]2.46,95%[CI](1.43-4.23)). The cancer risk for current drinkers with heavy alcohol consumption(>400g/week) significantly increased ([OR]1.66,95% [CI] (1.18-2.34))compared to never drinkers. Among current drinkers, for every 100g of alcohol consumed per week, the risk of cancer increased by 15%. Among current drinkers, those aged 53.5 years or older , had a significant increase in the risk of cancer ([OR]1.26,95% [CI](1.12-1.42), for those with triglycerides ≥150 mg/dL, the risk of cancer was even higher ([OR]1.50,95%[CI](1.20-1.88), P for interaction 0.018), and for those with high density lipoprotein cholesterol (HDLC)<40 mg/dL, the risk of cancer increased the greatest ([OR]2.03,95%[CI](1.36-3.04), P for interaction 0.005). Conclusions: Among middle-aged and elderly males in rural China, the risk of cancer significantly increased among former and heavy current drinkers compared with never drinkers. Age, triglycerides, and HDLC may increase the risk of cancer along with alcohol consumption.

scholarly journals Strong reduction of distal colorectal cancer incidence and mortality but no reduction of proximal colon cancer after screening colonoscopy: prospective cohort study

2020 ◽  
Author(s):  
Feng Guo ◽  
Chen Chen ◽  
Bernd Holleczek ◽  
Ben Schöttker ◽  
Michael Hoffmeister ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cohort Study ◽  
Cancer Incidence ◽  
Prospective Cohort ◽  
Flexible Sigmoidoscopy ◽  
No Reduction ◽  
Proximal Colon ◽  
Screening Colonoscopy ◽  
List Type ◽  
Incidence And Mortality

AbstractBackgroundA claimed advantage of colonoscopy over sigmoidoscopy in colorectal cancer (CRC) screening is prevention of CRC not only in the distal colon and rectum but also in the proximal colon. We aimed to assess the association of screening colonoscopy use with overall and site-specific CRC incidence and associated mortality.MethodsInformation on use of screening colonoscopy as well as potential confounding factors was obtained at baseline in 2000-2002, updated at 2-, 5-, and 8-year follow-up from 9207 participants aged 50-75 years without history of CRC in a statewide cohort study in Saarland, Germany. Covariate-adjusted associations of screening colonoscopy with CRC incidence and mortality, which were obtained through record linkage with the Saarland Cancer Registry and mortality statistics up to 2016, were assessed by Cox proportional hazards models with time-varying exposure information.FindingsDuring a median follow-up of 15·3 years, 227 participants were diagnosed with CRC and 81 died from CRC. Screening colonoscopy was associated with strongly reduced overall CRC incidence (adjusted hazard ratio, aHR 0·54, 95% confidence interval, CI 0·41-0·72) and mortality (aHR 0·39, 95% CI 0·24-0·63). However, strong incidence and mortality reduction was seen for distal CRC (aHRs 0·44, 95% CI 0·30-0·63, and 0·35, 95% CI 0·19-0·66, respectively) only, but not for proximal CRC (aHRs 0·99, 95% CI 0·58-1·68, and 0·72, 95% CI 0·29-1·81, respectively).ConclusionIn this large prospective cohort study from Germany, screening colonoscopy was associated with strong reduction in total and distal CRC incidence and mortality, but no reduction was seen for cancer incidence and mortality in the proximal colon.Research in contextEvidence before this studyMultiple randomized controlled trials have demonstrated that screening with flexible sigmoidoscopy can substantially reduce incidence and mortality from cancer in the distal colon and rectum.Evidence on the impact of screening colonoscopy on colorectal cancer incidence and mortality from randomized trials is lacking, and evidence from prospective cohort studies is very limited.In particular, it is highly uncertain to what extent screening colonoscopy can additionally reduce incidence and mortality from cancer in the proximal colon.Added value of this studyThis population-based, prospective statewide cohort study from Saarland/Germany with repeat updates of exposure information demonstrates major reduction of total and distal CRC incidence and mortality among people who underwent screening colonoscopy.However, no reduction of incidence and mortality from cancer in the proximal colon was observed.These results challenge the expectation of incremental effectiveness of colonoscopy screening over screening by flexible sigmoidoscopy in preventing colorectal cancer.Implications of all the available evidenceOur results may impact on recommendations, offers and use of colonoscopy versus flexible sigmoidoscopy for colorectal cancer screening.

Estrogen and colorectal cancer incidence and mortality in the Women's Health Initiative clinical trial.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3594-3594
Author(s):  
Sayeh Moazami Lavasani ◽  
Rowan T. Chlebowski ◽  
Ross L Prentice ◽  
Ikuko Kato ◽  
Jean Wactawski-Wende ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Trial ◽  
Waist Circumference ◽  
Cancer Incidence ◽  
Conjugated Equine Estrogen ◽  
Health Initiative ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
Colorectal Cancer Incidence

3594 Background: The preponderance of observational studies associate estrogen alone use with lower colorectal cancer incidence. In contrast, no difference in colorectal cancer incidence was seen in the Women's Health Initiative (WHI) randomized, controlled trial (RCT) of estrogen versus placebo after 7.1 years mean intervention. We now assess the influence of estrogen alone use on longer-term colorectal cancer incidence and mortality after an additional 5.6 years post-intervention follow-up. Methods: The WHI study was a randomized, double-blind, placebo-controlled clinical trial involving 10,739 postmenopausal women who had undergone prior hysterectomy and who were randomly assigned to receive daily 0.625 conjugated equine estrogen (n = 5279) or matching placebo (n = 5409). Colorectal cancer diagnosis rates and mortality were assessed after a mean of 7.1 years (standard deviation [SD] 1.1) of intervention and 12.7 years follow-up. Results: Colorectal cancer incidence in the treatment and control groups were almost equivalent, 0.15% diagnoses/year v 0.13% in the estrogen therapy arm and the placebo group, respectively (Hazard ratio [HR], 1.12; 95% Confidence Interval [CI], 0.83-1.52; P = 0.46). Bowel screening examinations were comparable in both groups throughout. For women age 70-79 at study entry, hormone therapy was associated with an increased risk of colorectal cancer, HR 1.71; 95% CI, (1.02-2.86). For women age 50-59 and 60-69, the respective HR’s and 95% CI were 0.86 (0.43-1.71) and 0.98 (0.64-1.49), p-interaction 0.165. For women with a waist circumference of > 88 cm, there was an increased risk of colorectal cancer, HR 1.53; 95% CI, 0.95-2.45 compared to 0.95 (0.66-1.39) for waist circumference of < 88 cm, p-interaction 0.124. Although not statistically significant, there was a higher number of colorectal cancer deaths in the hormone therapy arm (33 v 24 deaths; 0.05% v 0.04%; HR, 1.42; 95% CI, 0.84-2.41; P = 0.19). Conclusions: There were no significant differences in colorectal cancer incidence or mortality after long-term follow-up in the WHI RCT of conjugated equine estrogen. There was a suggestion of an elevation in colorectal cancer risk among older women randomized to estrogen. Clinical trial information: NCT00000611.

scholarly journals Colorectal cancer is a leading cause of cancer incidence and mortality among adults younger than 50 years in the USA: a SEER-based analysis with comparison to other young-onset cancers

2016 ◽  
Vol 65 (2) ◽  
pp. 311-315 ◽  
Author(s):  
Abhishek Bhandari ◽  
Melissa Woodhouse ◽  
Samir Gupta
Keyword(s):  
Colorectal Cancer ◽  
Young Adults ◽  
Cancer Incidence ◽  
Cancer Site ◽  
Cancer Death ◽  
Young Onset ◽  
Incident Cancer ◽  
Incidence And Mortality ◽  
The Usa ◽  
Incident Rates

Colorectal cancer (CRC) incidence and mortality are rising among young adults. Our aim was to contrast the relative incidence and mortality of CRC to other common cancers among young adults in the USA. We used Surveillance, Epidemiology, and End Results registry data to compare cancer site-specific and age-specific mortality and incident rates for adults younger than age 50. We summarized extracted data, both overall, and stratified by sex. We found CRC was the third leading cause of cancer death among adults younger than age 50, after breast and lung cancer (1.67 cases per 100,000). Among young women, CRC was the fourth leading cause of cancer death (1.51 per 100,000). Among young men, CRC was the second leading cause of cancer death (1.82 cases per 100,000). CRC was the second most incident cancer among young adults for men and women combined. Among men, CRC was the second most incident cancer after age 30, with 4.9, 9.0, 16.4, and 30.8 cases per 100,000 for ages 30–34, 35–39, 40–44, and 45–49 years, respectively. Among women, CRC incidence was similar with 4.2, 7.6, 15.3, and 25.9 cases per 100,000 for ages 30–34, 35–39, 40–44, and 45–49 years, respectively. These results show that CRC is a leading cause of cancer incidence and mortality among young adults in the USA, relative to other cancers. Given trends toward increasing rates of CRC among young adults, strategies for identifying individuals at risk for young-onset CRC who might benefit from early age of screening initiation merit investigation.

scholarly journals Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 614-614
Author(s):  
Suzanne Orchard ◽  
Jonathan Broder ◽  
Jessica Lockery ◽  
Peter Gibbs ◽  
Robyn Woods ◽  
...  
Keyword(s):  
Older Adults ◽  
Cancer Risk ◽  
Cancer Incidence ◽  
Community Dwelling ◽  
Uncontrolled Diabetes ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
Significant Difference ◽  
Risk Of Cancer ◽  
Related Mortality

Abstract Diabetes increases risk of malignancies, and this association increases with age. Metformin may protect against cancer development and progression, but results are mixed and limited to younger cohorts. We examined whether metformin, in the presence or absence of aspirin, reduces incident cancer and cancer-related mortality in older adults. ASPirin in Reducing Events in the Elderly (ASPREE) was a primary prevention trial of daily aspirin vs placebo which enrolled community-dwelling adults from Australia (70+ years) and the US (65+ years for minorities) followed for a median of 4.7 years. Invasive cancer was adjudicated by an expert panel. Cox proportional-hazards models, controlling for age at randomization and known cancer risk factors, were used to analyse the relationship between baseline metformin use, randomized treatment arm, cancer incidence (first in-trial cancer) and mortality. For participants with controlled diabetes, there was a significant reduction in cancer mortality in metformin users compared to nonusers (Adjusted [Adj] HR=0.24, 95%CI=0.07, 0.80), but not for cancer incidence (Adj HR=0.61, 95%CI=0.29, 1.27). For participants with uncontrolled diabetes, there was no significant difference in cancer incidence (Adj HR=0.95, 95%CI=0.66, 1.38) or mortality (Adj HR=1.18, 95%CI=0.62, 2.26) between metformin and non-metformin users. Uncontrolled diabetes, irrespective of metformin use, increased risk of cancer incidence and mortality compared to non-diabetics. Aspirin did not modify the effect of metformin on cancer incidence or mortality. Our findings show that metformin may have protective effects against cancer-related mortality for those older persons whose diabetes is well-controlled, and underscores the importance of diabetes control to minimise cancer risk.

scholarly journals Serum Uric Acid Increases Risk of Cancer Incidence and Mortality: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Shushan Yan ◽  
Pengjun Zhang ◽  
Wei Xu ◽  
Yuqing Liu ◽  
Bin Wang ◽  
...  
Keyword(s):  
Cancer Incidence ◽  
Meta Analysis ◽  
Positive Association ◽  
Epidemiological Studies ◽  
Protective Role ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
Total Cancer ◽  
Risk Of Cancer

SUA is a potent antioxidant and thus may play a protective role against cancer. Many epidemiological studies have investigated this hypothesis but provided inconsistent and inconclusive findings. We aimed to precisely elucidate the association between SUA levels and cancer by pooling all available publications. Totally, 5 independent studies with 456,053 subjects and 12 with 632,472 subjects were identified after a comprehensive literature screening from PubMed, Embase, and Web of Science. The pooled RRs showed that individuals with high SUA levels were at an increased risk of total cancer incidence (RR=1.03, 95% CI 1.01–1.05,P=0.007). Positive association between high SUA levels and total cancer incidence was observed in males but not females (for men:RR=1.05, 95% CI 1.02–1.08,P=0.002; for women,RR=1.01, 95% CI 0.98–1.04,P=0.512). Besides, high SUA levels were associated with an elevated risk of total cancer mortality (RR=1.17, 95% CI 1.04–1.32,P=0.010), particularly in females (RR=1.25, 95% CI 1.07–1.45,P=0.004). The study suggests that high SUA levels increase the risk of total cancer incidence and mortality. The data do not support the hypothesis of a protective role of SUA in cancer.

A 5-Year Continued Follow-up of Cancer Risk and All-Cause Mortality Among Norwegian Military Peacekeepers Deployed to Kosovo During 1999–2016

2019 ◽  
Author(s):  
Leif Aage Strand ◽  
Jan Ivar Martinsen ◽  
Einar Kristian Borud
Keyword(s):  
Cancer Risk ◽  
Cancer Incidence ◽  
News Media ◽  
Brain Cancer ◽  
Poisson Regression ◽  
Length Of Service ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
Risk Of Cancer

Abstract Introduction In 2012, Norwegian news media reported on cases of brain cancer among Norwegian peacekeeping troops who served in Kosovo, allegedly caused by exposure to depleted uranium fired during airstrikes before the peacekeepers arrived in 1999. A first study followed 6076 military men and women with peacekeeping service in Kosovo during 1999–2011 for cancers and deaths throughout 2011. The study did not support to the idea that peacekeeping service in Kosovo could lead to increased risk of brain cancer or other cancers. However, the average time of follow-up (10.6 years) was rather short for cancer development; therefore the aim of the present study was to evaluate cancer risk and general mortality in an updated cohort after 5 years of additional follow-up. Materials and Methods The updated cohort consisted of 6,159 peacekeepers (5,884 men and 275 women) who served in Kosovo during 1999–2016 and were followed for cancer incidence and mortality from all causes combined throughout 2016. We calculated standardized incidence ratios (SIR) for cancer and standardized mortality ratios (SMR) from national population rates. Poisson regression was used to assess the effect of length of service (<1 year vs. ≥1 year) on cancer risk. Results We observed 149 cancer cases and 75 deaths in the updated cohort. Observed cancer incidence did not exceed national rates. In men, the SIR for brain cancer was 0.73 (95% confidence interval (CI) 0.32–1.44), based on eight cases, while the risk of colon cancer was lowered (SIR = 0.14, 95% CI 0.00–0.79). The Poisson regression showed no effect of service duration on all-site cancer incidence. Mortality from all causes combined was lower than expected (SMR = 0.62, 95% CI 0.49–0.78) and in accordance with a “healthy soldier effect”. Conclusion The extended follow-up did not give support to the suggestion that peacekeeping service in Kosovo could lead to increased risk of cancer.

scholarly journals The relation between systemic inflammation and incident cancer in patients with stable cardiovascular disease: a cohort study

2019 ◽  
Vol 40 (48) ◽  
pp. 3901-3909 ◽  
Author(s):  
Cilie C van’t Klooster ◽  
Paul M Ridker ◽  
Jesper Hjortnaes ◽  
Yolanda van der Graaf ◽  
Folkert W Asselbergs ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Low Grade ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Incident Cancer ◽  
Risk Of Cancer ◽  
Low Grade Inflammation

Abstract Aims Low-grade inflammation, measured by elevated plasma concentrations of high-sensitive C-reactive protein (CRP), is a risk factor for cardiovascular disease (CVD). There is evidence that low-grade inflammation is also related to a higher risk of cancer. The present prospective cohort study evaluates the relation between low-grade systemic inflammation and risk of cancer in patients with stable CVD. Methods and results In total, 7178 patients with stable CVD and plasma CRP levels ≤10 mg/L were included. Data were linked to the Dutch national cancer registry. Cox regression models were fitted to study the relation between CRP and incident CVD and cancer. After a median follow-up time of 8.3 years (interquartile range 4.6–12.3) 1072 incident cancer diagnoses were observed. C-reactive protein concentration was related to total cancer [hazard ratio (HR) 1.35; 95% confidence interval (CI) 1.10–1.65] comparing last quintile to first quintile of CRP. Especially lung cancer, independent of histopathological subtype, was related to CRP (HR 3.39; 95% CI 2.02–5.69 comparing last to first quintile of CRP). Incidence of epithelial neoplasms and especially squamous cell neoplasms were related to CRP concentration, irrespective of anatomical location. Sensitivity analyses after excluding patients with a cancer diagnosis within 1, 2, and 5 years of follow-up showed similar results. No effect modification was observed by smoking status or time since smoking cessation (P-values for interaction &gt; 0.05). Conclusion Chronic systemic low-grade inflammation, measured by CRP levels ≤10 mg/L, is a risk factor for incident cancer, markedly lung cancer, in patients with stable CVD. The relation between inflammation and incident cancer is seen in former and current smokers and is uncertain in never smokers.

Sign in / Sign up

Export Citation Format

Share Document