Baseline C-Reactive Protein Is Associated With Incident Cancer and Survival in Patients With Cancer

2009 ◽  
Vol 27 (13) ◽  
pp. 2217-2224 ◽  
Author(s):  
Kristine H. Allin ◽  
Stig E. Bojesen ◽  
Børge G. Nordestgaard
Keyword(s):  
Colorectal Cancer ◽  
Lung Cancer ◽  
General Population ◽  
Early Death ◽  
C Reactive Protein ◽  
Patients With Cancer ◽  
Reactive Protein ◽  
Hazard Ratios ◽  
Incident Cancer

Purpose We tested the hypothesis that baseline plasma levels of C-reactive protein (CRP) are associated with risk of incident cancer in the general population and early death in patients with cancer. Patients and Methods A total of 10,408 individuals from the Danish general population who had CRP measured at baseline were observed for up to 16 years; 1,624 developed cancer, and of these, 998 patients died during follow-up. Follow-up was 100% complete. We excluded individuals with a cancer diagnosis at baseline. Results Baseline CRP levels more than 3 versus less than 1 mg/L were associated with multifactorially adjusted hazard ratios of 1.3 (95% CI, 1.0 to 1.6) for cancer of any type, 2.2 (95% CI, 1.0 to 4.6) for lung cancer, 1.9 (95% CI, 0.8 to 4.6) for colorectal cancer, and 0.7 (95% CI, 0.4 to 1.4) for breast cancer. Corresponding hazard ratios for the highest versus the lowest quintile of baseline CRP levels were 1.3 (95% CI, 1.0 to 1.6), 2.1 (95% CI, 1.2 to 3.8), 1.7 (95% CI, 0.8 to 3.2), and 0.9 (95% CI, 0.5 to 1.7), respectively. Multifactorially adjusted hazard ratios for early death in patients with cancer were 1.8 (95% CI, 1.2 to 2.7) for CRP more than 3 versus less than 1 mg/L and 1.4 (95% CI, 1.1 to 1.7) for the highest versus the lowest quintile. Elevated CRP levels were associated with early death in patients with cancer having localized disease, but not in those with metastases (interaction; P = .03). Conclusion Elevated levels of CRP in cancer-free individuals are associated with increased risk of cancer of any type, of lung cancer, and possibly of colorectal cancer. Moreover, elevated levels of baseline CRP associate with early death after a diagnosis of any cancer, particularly in patients without metastases.

Association of baseline c-reactive protein with incident cancer and survival in cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 11052-11052
Author(s):  
K. H. Allin ◽  
S. E. Bojesen ◽  
B. G. Nordestgaard
Keyword(s):  
Colorectal Cancer ◽  
Lung Cancer ◽  
General Population ◽  
Cancer Patients ◽  
Early Death ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hazard Ratios ◽  
Incident Cancer

11052 Background: We tested the hypothesis that baseline plasma levels of C-reactive protein (CRP) associate with risk of incident cancer in the general population, and early death in cancer patients. Methods: 10,408 individuals from the Danish general population, who had CRP measured at baseline, were followed for up to 16 years; 1,624 developed cancer and of these, 998 died during follow-up. Follow-up was 100% complete. We excluded individuals with a cancer diagnosis at baseline. Results: Baseline CRP levels >3 vs. <1 mg/L were associated with multifactorially adjusted hazard ratios of 1.3 (95% CI, 1.0–1.6) for cancer of any type, of 2.2 (1.0–4.6) for lung cancer, of 1.9 (0.8–4.6) for colorectal cancer, and of 0.7 (0.4–1.4) for breast cancer. Corresponding hazard ratios for the highest vs. the lowest quintile of baseline CRP levels were 1.3 (1.0–1.6), 2.1 (1.2–3.8), 1.7 (0.8–3.2), and 0.9 (0.5–1.7), respectively. Multifactorially adjusted hazard ratios for early death in cancer patients were 1.8 (1.2–2.7) for CRP >3 vs. <1 mg/L and 1.4 (1.1–1.7) for the highest vs. the lowest quintile. Elevated CRP levels associated with early death in cancer patients with localized disease, but not in cancer patients with metastases (interaction; P=.03). Conclusions: Elevated levels of CRP in cancer-free individuals are associated with increased risk of cancer of any type, of lung cancer, and possibly of colorectal cancer. Moreover, elevated levels of baseline CRP associate with early death after a diagnosis of any cancer, particularly in patients without metastases. No significant financial relationships to disclose.

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.

Risk Of Solid Subsequent Malignant Neoplasms (SMNs) With Extended Follow-Up Of Childhood Hodgkin Lymphoma (HL) Survivors Is Comparable To The Risk In Known High-Risk Groups Within The General Population: Report From The Late Effects Study Group (LESG)

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2992-2992
Author(s):  
Smita Bhatia ◽  
Cor van den Bos ◽  
Can-Lan Sun ◽  
Jillian Birch ◽  
Lisa Diller ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Lung Cancer ◽  
High Risk ◽  
General Population ◽  
Clin Oncol ◽  
Cumulative Incidence ◽  
Risk Groups ◽  
Increased Risk

Abstract Background We describe the pattern and incidence of SMNs with 10 additional years of follow-up of an international cohort (Bhatia, N Engl J Med, 1996; Bhatia, J Clin Oncol, 2003) of children with HL diagnosed between 1955 and 1986 at age 16 y or younger. Methods Medical record review was used to identify SMNs, define vital status and describe therapeutic exposures. Pathology reports served to validate SMNs. Cumulative incidence (CI) utilized competing risk methods. Standardized incidence ratio (SIR) and absolute excess risk (AER/10,000 p-y) utilized age-, gender- and year-matched rates in the general population. Cox regression techniques (using calendar time as time scale) identified predictors of SMN risk. Results The cohort included 1023 patients diagnosed with HL at a median age of 11 y, and followed for a median of 26.8 y (IQR, 16.4-33.7). Eighty-nine percent had received radiation, either alone (22%), or in combination with chemotherapy (67%). Alkylating agent (AA) score was defined as follows: 1 AA for 6 m = AA score of 1; 2 AA for 6 m or 1 AA for 12 m = AA score of 2, etc. The AA score was 1-2 for 54% and 3+ for 16%; 30% did not receive AA. A total of 188 solid SMNs developed in 139 patients (breast [54], thyroid [24], lung [11], colorectal [11], bone [8], other malignancies [80]. Table summarizes SIR (95%CI), CI, and AER by attained age. The cohort was at an 11.1-fold increased risk of developing solid SMNs (excluding non-melanoma skin cancers) compared with the general population (95% CI, 9.4-13.0). CI of solid SMNs was 25.2% at 40 y from HL diagnosis (Fig 1). Among patients aged ≥40 y, 79% of total AER was attributable to breast, thyroid, colorectal and lung SMNs (Table). Thirty-seven patients developed >1 solid SMN; the cumulative incidence of the 2nd SMN was 19.6% at 10 years from diagnosis of the 1st SMN. Breast Cancer: Females (n=41) had a 20.9-fold increased risk, and males (n=3) a 45.8-fold increased risk c/w general population. Age at HL of 10-16 y vs. <10 y (RR=9.7, 95%CI, 2.3-40.6, p=0.002), and exposure to chest radiation (RR=5.9, 95%CI, 1.4-25.9) were associated with increased risk. Among females aged 10-16 y at chest radiation, cumulative incidence was 24.3% by age 45 y, as opposed to 2.6% for those <10 y, p=0.001 (Fig 2). Exposure to AA was associated with a lower risk (RR=0.4, p=0.002). Diagnosis of HL after 1975 was associated with decreased risk (RR=0.25, 95%CI 0.12-0.53), explained, in part by the increasing use of AA after 1975 (78%) vs. before 1975 (61%). By age 40 y, the risk of breast cancer among females exposed to chest radiation at age 10-16 y (18.2%) was comparable to the risk for BRCA1 mutation carriers (15%-20% by age 40 y; Chen, J Clin Oncol, 2007). Lung cancer: Ten of 11 lung cancer cases were diagnosed in males (males: SIR=24.7; females: SIR=3.2, p=0.05); all had received neck/chest radiation. The CI of lung cancer among males was 3.8% by age 50 y, comparable to the risk among male smokers (2% by age 50 y, Bilello, Clinics Chest Med, 2002). Colorectal cancer: There was a 11.5-fold increased risk c/w general population. The CI among those with abdominal/pelvic radiation was 4.1% by age 50 y ; this risk is higher than that observed in individuals with ≥2 first degree relatives affected with colorectal cancer (1.2% by age 50 y, Butterworth, Eur J Cancer, 2006). Thyroid cancer: Survivors had a 22.2-fold increased risk; all developed within radiation field. Females (RR=4.3, 95%CI 1.8-10.4) were at increased risk. Conclusion In this cohort of HL survivors with 20,344 p-y of follow-up, the greatest excess risk of SMNs among those > 40 y was attributable to breast, thyroid, colorectal and lung SMNs. Observed risks for the most common SMNs were comparable to or greater than known high-risk groups within the general population. Disclosures: No relevant conflicts of interest to declare.

scholarly journals C-Reactive Protein and Risk of Lung Cancer

2010 ◽  
Vol 28 (16) ◽  
pp. 2719-2726 ◽  
Author(s):  
Anil K. Chaturvedi ◽  
Neil E. Caporaso ◽  
Hormuzd A. Katki ◽  
Hui-Lee Wong ◽  
Nilanjan Chatterjee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Risk ◽  
Lung Cancer Risk ◽  
Smoking Status ◽  
Lung Carcinogenesis ◽  
C Reactive Protein ◽  
Baseline Serum ◽  
Reactive Protein ◽  
Former Smokers

Purpose Chronic inflammation could play a role in lung carcinogenesis, underscoring the potential for lung cancer prevention and screening. We investigated the association of circulating high-sensitivity C-reactive protein (CRP, an inflammation biomarker) and CRP single nucleotide polymorphisms (SNPs) with prospective lung cancer risk. Patients and Methods We conducted a nested case-control study of 592 lung cancer patients and 670 controls with available prediagnostic serum and 378 patients and 447 controls with DNA within the screening arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (N = 77,464). Controls were matched to patients on age, sex, entry year, follow-up time, and smoking. We measured CRP levels in baseline serum samples and genotyped five common CRP SNPs. Results Elevated CRP levels were associated with increased lung cancer risk (odds ratio [OR], 1.98; 95% CI, 1.35 to 2.89; P-trend < .001 for fourth quartile [Q4, ≥ 5.6 mg/L] v Q1 [< 1.0 mg/L]). The CRP association did not differ significantly by histology, follow-up time, or smoking status, but was most apparent for squamous cell carcinomas (OR, 2.92; 95% CI, 1.30 to 6.54), 2 to 5 years before lung cancer diagnosis (OR, 2.33; 95% CI, 1.24 to 4.39), and among former smokers (OR, 2.48; 95% CI, 1.53 to 4.03) and current smokers (OR, 1.90; 95% CI, 1.06 to 3.41). Although CRP SNPs and haplotypes were associated with CRP levels, they were not associated with lung cancer risk. Ten-year standardized absolute risks of lung cancer were higher with elevated CRP levels among former smokers (Q4: 2.55%; 95% CI, 1.98% to 3.27% v Q1: 1.39%; 95% CI, 1.07% to 1.81%) and current smokers (Q4: 7.37%; 95% CI, 5.81% to 9.33% v Q1: 4.03%; 95% CI, 3.01% to 5.40%). Conclusion Elevated CRP levels are associated with subsequently increased lung cancer risk, suggesting an etiologic role for chronic pulmonary inflammation in lung carcinogenesis.

Elevated Plasma YKL-40 Predicts Increased Risk of Gastrointestinal Cancer and Decreased Survival After Any Cancer Diagnosis in the General Population

2009 ◽  
Vol 27 (4) ◽  
pp. 572-578 ◽  
Author(s):  
Julia S. Johansen ◽  
Stig E. Bojesen ◽  
Anne K. Mylin ◽  
Ruth Frikke-Schmidt ◽  
Paul A. Price ◽  
...  
Keyword(s):  
General Population ◽  
Cancer Diagnosis ◽  
Gastrointestinal Cancer ◽  
Early Death ◽  
Elevated Plasma ◽  
Hazard Ratios ◽  
Incident Cancer ◽  
Heart Study ◽  
Increased Risk ◽  
Risk Of Cancer

PurposeElevated plasma YKL-40 is a biomarker of poor prognosis in cancer patients. We tested the hypotheses that elevated plasma YKL-40 predicts risk of cancer as well as survival after a cancer diagnosis in the general population.Patients and MethodsA prospective cohort study of 8,899 subjects (20 to 95 years) from the Danish general population, the Copenhagen City Heart Study, observed for 11 years for cancer incidence and 14 years for death: 1,432 participants had a first incident cancer, 968 of these died. Hazard ratios (HRs) for cancer events and death after events according to plasma YKL-40 in sex and 10 years age percentile categories: 0% to 33%, 34% to 66%, 67% to 90%, 91% to 95%, and 96% to 100%.ResultsThe cumulative incidence of gastrointestinal cancer increased with increasing YKL-40 (trend P < .0001). Multifactorially adjusted HRs for gastrointestinal cancer were 1.0 (95% CI, 0.7 to 1.5) for YKL-40 in category 34% to 66%, 1.5 for 67% to 90% (95% CI, 1.0 to 2.3), 2.4 for 91% to 95%, (95% CI, 1.3 to 4.6), and 3.4 for 96% to 100% (95% CI, 1.9 to 6.1) versus YKL-40 category 0% to 33% (P < .0001). Participants with any cancer event and YKL-40 category 91% to 100% had a median survival time after the diagnosis of 1 year versus 4 years in participants with YKL-40 category 0% to 33% (P < .0001). Corresponding values for gastrointestinal cancer were 6 months versus 1 year (P = .007). Multifactorially adjusted HRs for early death were 1.8 (95% CI, 1.3 to 2.5; P < .0001) after any cancer and 2.4 (95% CI, 1.3 to 4.3; P = .005) after gastrointestinal cancer in participants with YKL-40 category 91% to 100% versus 0% to 33%.ConclusionIn the general population, elevated plasma YKL-40 predicts increased risk of gastrointestinal cancer and decreased survival after any cancer diagnosis.

Serum C-reactive protein levels and colorectal cancer mortality.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 360-360
Author(s):  
Abhishek Goyal ◽  
Abby B. Siegel
Keyword(s):  
Colorectal Cancer ◽  
Cancer Mortality ◽  
Risk Groups ◽  
Nhanes Iii ◽  
Protein Levels ◽  
Reactive Protein ◽  
Representative Study ◽  
Hazard Ratios ◽  
Valid Estimate

360 Background: Chronic inflammation has been causally linked to colorectal cancer (CRC), and use of NSAIDs has been associated with reduced risk. Prediagnostic C-reactive protien (CRP) levels, a highly sensitive marker of inflammation, have been weakly associated with increased CRC incidence. However, their relationship with CRC mortality has not been studied well. We hypothesized that elevated baseline CRP levels in general population will predict increased CRC mortality. Methods: This cohort study used CRP data from the Third National Health and Nutrition Examination survey, 1988-94 (NHANES III), with follow-up through 2006. Of the 15,832 eligible adults, NHANES III classified 65% as having CRP levels below detection (≤0.21mg/dL). Using this as the reference, we categorized the remaining participants in three approximately equal groups, and calculated hazard ratios for CRC, all-cancer mortality excluding CRC, and overall mortality due to non-cancer causes. Results: Median follow-up period was 14.2 years. In age adjusted (not shown) and multivariable adjusted models (Table), we observed strong, dose-response associations between CRP levels and CRC mortality. Associations between CRP levels and mortality due to other causes were much weaker. Conclusions: In this large, representative study of U.S. adults, we obtained significantly higher HRs for CRC mortality, as compared to mortality from other cancer and non-cancer causes, making these results unlikely to be explained by residual confounding or other biases. Further, since mortality is a function of both incidence and survival, it provides a more valid estimate of the prognostic value of CRP compared to incidence alone. Further evaluation of CRP may help stratify high risk groups for screening and prognosis, and potentially identify those who might benefit from anti-inflammatory therapy. [Table: see text]

scholarly journals Circulating high sensitivity C reactive protein concentrations and risk of lung cancer: nested case-control study within Lung Cancer Cohort Consortium

BMJ ◽  
2019 ◽  
pp. k4981 ◽  
Author(s):  
David C Muller ◽  
Tricia L Larose ◽  
Allison Hodge ◽  
Florence Guida ◽  
Arnulf Langhammer ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Case Control Study ◽  
Smoking Status ◽  
High Sensitivity ◽  
Case Control ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Nested Case Control ◽  
Control Study

Abstract Objectives To conduct a comprehensive analysis of prospectively measured circulating high sensitivity C reactive protein (hsCRP) concentration and risk of lung cancer overall, by smoking status (never, former, and current smokers), and histological sub-type. Design Nested case-control study. Setting 20 population based cohort studies in Asia, Europe, Australia, and the United States. Participants 5299 patients with incident lung cancer, with individually incidence density matched controls. Exposure Circulating hsCRP concentrations in prediagnostic serum or plasma samples. Main outcome measure Incident lung cancer diagnosis. Results A positive association between circulating hsCRP concentration and the risk of lung cancer for current (odds ratio associated with a doubling in hsCRP concentration 1.09, 95% confidence interval 1.05 to 1.13) and former smokers (1.09, 1.04 to 1.14) was observed, but not for never smokers (P<0.01 for interaction). This association was strong and consistent across all histological subtypes, except for adenocarcinoma, which was not strongly associated with hsCRP concentration regardless of smoking status (odds ratio for adenocarcinoma overall 0.97, 95% confidence interval 0.94 to 1.01). The association between circulating hsCRP concentration and the risk of lung cancer was strongest in the first two years of follow-up for former and current smokers. Including hsCRP concentration in a risk model, in addition to smoking based variables, did not improve risk discrimination overall, but slightly improved discrimination for cancers diagnosed in the first two years of follow-up. Conclusions Former and current smokers with higher circulating hsCRP concentrations had a higher risk of lung cancer overall. Circulating hsCRP concentration was not associated with the risk of lung adenocarcinoma. Circulating hsCRP concentration could be a prediagnostic marker of lung cancer rather than a causal risk factor.

The impact of lung cancer resection surgery on fibrinogen and C-reactive protein and their relationship with patients outcomes: A prospective follow up study

2016 ◽  
Vol 16 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Amanda Souza Araújo ◽  
Ingrid Correia Nogueira ◽  
Antero Gomes Neto ◽  
Israel Lopes de Medeiros ◽  
Maria Tereza Aguiar Pessoa Morano ◽  
...  
Keyword(s):  
Lung Cancer ◽  
C Reactive Protein ◽  
Cancer Resection ◽  
Reactive Protein ◽  
Follow Up Study ◽  
The Impact
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