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]

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.

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.

scholarly journals High risk groups for severe COVID-19 in a whole of population cohort in Australia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bette Liu ◽  
Paula Spokes ◽  
Wenqiang He ◽  
John Kaldor
Keyword(s):  
Socioeconomic Status ◽  
New South ◽  
Severe Disease ◽  
Risk Groups ◽  
Prevention Strategies ◽  
Complete Case ◽  
Relative Risks ◽  
South Wales ◽  
Hazard Ratios

Abstract Background Increasing age is the strongest known risk factor for severe COVID-19 disease but information on other factors is more limited. Methods All cases of COVID-19 diagnosed from January–October 2020 in New South Wales Australia were followed for COVID-19-related hospitalisations, intensive care unit (ICU) admissions and deaths through record linkage. Adjusted hazard ratios (aHR) for severe COVID-19 disease, measured by hospitalisation or death, or very severe COVID-19, measured by ICU admission or death according to age, sex, socioeconomic status and co-morbidities were estimated. Results Of 4054 confirmed cases, 468 (11.5%) were classified as having severe COVID-19 and 190 (4.7%) as having very severe disease. After adjusting for sex, socioeconomic status and comorbidities, increasing age led to the greatest risk of very severe disease. Compared to those 30–39 years, the aHR for ICU or death from COVID-19 was 4.45 in those 70–79 years; 8.43 in those 80–89 years; 16.19 in those 90+ years. After age, relative risks for very severe disease associated with other factors were more moderate: males vs females aHR 1.40 (95%CI 1.04–1.88); immunosuppressive conditions vs none aHR 2.20 (1.35–3.57); diabetes vs none aHR 1.88 (1.33–2.67); chronic lung disease vs none aHR 1.68 (1.18–2.38); obesity vs not obese aHR 1.52 (1.05–2.21). More comorbidities was associated with significantly greater risk; comparing those with 3+ comorbidities to those with none, aHR 5.34 (3.15–9.04). Conclusions In a setting with high COVID-19 case ascertainment and almost complete case follow-up, we found the risk of very severe disease varies by age, sex and presence of comorbidities. This variation should be considered in targeting prevention strategies.

Abstract P096: Maternal Serum C-Reactive Protein Levels During Pregnancy and Risk for High C-Reactive Protein 7-13 Years Later

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Bonny Rockette-Wagner ◽  
Claudia Holzman ◽  
Bertha L Bullen ◽  
Andrew D Althouse ◽  
Janet M Catov
Keyword(s):  
Relative Risk ◽  
Weight Change ◽  
Elevated Serum ◽  
Maternal Serum ◽  
Health Study ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Inflammatory Status

Introduction: Elevated serum C-reactive protein (CRP) can be a marker of disease activity involving inflammation, such as pregnancy complications and cardiovascular disease (CVD). Systemically high levels of CRP in women, including during pregnancy, may indicate higher risk for CVD. It is unknown if CRP measured during the pro-inflammatory state of pregnancy correlates with concentrations assessed 7-13 years after delivery. Hypothesis: Concentrations of CRP assessed during pregnancy will be related to CRP measured several years after pregnancy, independent of weight gain. Methods: We studied the first 252 women enrolled in the follow-up of the Pregnancy Outcomes and Community Health Study (POUCHmoms 2011-2013) with complete CRP data for the pregnancy (mean gestational age: 22.36 [2.22] weeks) and POUCHmoms visits (mean follow-up: 10.76 [1.38] years). The relative risk for high hsCRP (≥ 3.39 μg/ml) at the follow-up visit, related to quartiles of CRP during pregnancy, was examined using stepwise regression models. Results: Median (IQR) levels of pregnancy CRP and hsCRP at the follow-up visit were 5.68 [3.08, 9.76] and 3.39 [0.69, 9.73] μg/ml, respectively. Although absolute values of hsCRP at follow-up were generally lower than pregnancy CRP, 56% of women in the top and bottom quartiles of pregnancy CRP (71 of 126) were in the same quartile for hsCRP at follow-up (figure). The relative risk of having high hsCRP (≥ 3.39 μg/ml) at follow-up ranged from 2.7-5.2 for the 2 nd - 4 th quartiles of pregnancy CRP (vs. the 1st quartile). Controlling for pre-pregnancy BMI and follow-up weight change, the relative risk of having high hsCRP at follow-up was significantly higher for the 2 nd (1.15 [1.02-1.30]),3 rd (1.19 [1.05-1.35), and 4 th (1.22 [1.05-1.41]) quartiles of pregnancy CRP. Conclusions: Pregnancy CRP levels are related to hsCRP levels several years later in this cohort of women, even after adjusting for pre-pregnancy BMI and follow-up weight change. CRP assessed in pregnancy may reflect inflammatory status later in life.

scholarly journals P562 5-ASA in ulcerative colitis: Are they really needed in the biological therapy era?

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S474-S474
Author(s):  
C Arieira ◽  
F Dias de Castro ◽  
T Cúrdia Gonçalves ◽  
M J Moreira ◽  
J Cotter
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
Biologic Therapy ◽  
Fecal Calprotectin ◽  
Inflammatory Biomarkers ◽  
Faecal Calprotectin ◽  
Reactive Protein ◽  
Maintenance Of Remission ◽  
Treatment Escalation

Abstract Background Biologic therapy has demonstrated efficacy for induction and maintenance of remission in ulcerative colitis (UC). However, it remains unclear whether oral aminosalicylates (5-ASA) should be continued or stopped after treatment escalation to biologics. The aim of the study was to evaluate differences in inflammatory biomarkers or the occurrence of complications in UC patients being treated with a combination of 5-ASA and biologics vs. biologics alone. Methods Retrospective study, including patients with UC and on biologic therapy with a minimum follow-up of 6 months. Collected inflammatory biomarkers were faecal calprotectin, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The occurrence of complications was defined as the need of hospitalisation, need of corticosteroids or other top-up therapy, surgery and the occurrence of dysplasia or colorectal cancer. Results We included 65 patients with UC, 56.9% female with a mean age of 32.8 (±12.8) years. The median follow-up was 30 (6–132) months. Regarding extension, 61.5% were E3, 35.4% E2 and 3.1% E1. While 44 patients (67.7%) were on 5-ASA and biologics (infliximab = 32, adalimumab = 6, vedolizumab = 6), 21 (32.3%) were on biologics alone (infliximab = 13, adalimumab = 3, vedolizumab = 5). The median duration of biologic therapy was 30 (6–126) months. Regarding baseline characteristics, including age, gender, duration of the disease or biologic therapy and age at UC diagnosis, there were no differences between groups. No differences regarding inflammatory biomarkers were observed – fecal calprotectin (p = 0.39), CRP (p = 0.9) and ESR (p = 0.61). No differences were found regarding complications, namely the need of hospitalisation (p = 0.06) or need of corticosteroids (p = 0.89). Only one patient developed dysplasia (under infliximab and 5-ASA). Any of the included patients needed surgery or developed colorectal cancer. Conclusion About two-thirds of the UC patients under biologics are co-treated with 5-ASA. No differences between UC patients under combination biologics+5-ASA vs. biologics alone were found regarding inflammatory biomarkers or the occurrence of complications. These results raise the question if continuing 5-ASA in UC patients under biologics is really necessary.

scholarly journals Association between the 2018 WCRF/AICR and the Low-Risk Lifestyle Scores with Colorectal Cancer Risk in the Predimed Study

2020 ◽  
Vol 9 (4) ◽  
pp. 1215
Author(s):  
Laura Barrubés ◽  
Nancy Babio ◽  
Pablo Hernández-Alonso ◽  
Estefania Toledo ◽  
Judith B. Ramírez Sabio ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Research ◽  
Cardiovascular Risk ◽  
Longitudinal Studies ◽  
Smoking Status ◽  
Low Risk ◽  
High Cardiovascular Risk ◽  
Hazard Ratios ◽  
Score Range

Limited longitudinal studies have been conducted to evaluate colorectal cancer (CRC) incidence based on the updated 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations or other global lifestyle indices, and none in aged populations at high cardiovascular risk. We aimed to assess the association between CRC incidence and adherence to two emerging lifestyles indices (2018 WCRF/AICR score and another low-risk lifestyle (LRL) score comprising smoking status, alcohol consumption, physical activity, diet, and body mass index) in the Spanish PREvencion con DIeta MEDiterranea (PREDIMED) cohort. We studied 7216 elderly men and women at high cardiovascular risk. The 2018 WCRF/AICR and LRL scores were calculated. Multivariable Cox proportional regression models were fitted to estimate the HRs (hazard ratios) and 95% confidence intervals (CIs) for incident CRC events. During a median interquartile range (IQR) follow-up of 6.0 (4.4–7.3) years, 97 CRC events were considered. A significant linear association was observed between each 1-point increment in the WCRF/AICR score (score range from 0 to 7) and CRC risk (HR (95% CI) = 0.79 (0.63–0.99)). Similarly, each 1-point increment in the LRL score (score range from 0 to 5) was associated with a 22% reduction in CRC risk (0.78 (0.64–0.96)). Adhering to emergent lifestyle scores might substantially reduce CRC incidence in elderly individuals. Further longitudinal studies, which take different lifestyle indexes into account, are warranted in the future.

High-Sensitivity C-Reactive Protein Levels and Cancer Mortality

2012 ◽  
Vol 21 (11) ◽  
pp. 2076-2086 ◽  
Author(s):  
Young-Jin Ko ◽  
Young-Min Kwon ◽  
Kyae Hyung Kim ◽  
Ho-Chun Choi ◽  
So Hyun Chun ◽  
...  
Keyword(s):  
Cancer Mortality ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

scholarly journals Colorectal Cancer and Serum C-reactive Protein Levels: a Case-control Study Nested in the JACC Study

2005 ◽  
Vol 15 (Supplement_II) ◽  
pp. S185-S189 ◽  
Author(s):  
Yoshinori Ito ◽  
Koji Suzuki ◽  
Koji Tamakoshi ◽  
Kenji Wakai ◽  
Masayo Kojima ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Case Control Study ◽  
Case Control ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Control Study

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.

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