Circulating C-Reactive Protein Concentrations and Risks of Colon and Rectal Cancer: A Nested Case-Control Study Within the European Prospective Investigation into Cancer and Nutrition

摘要

The authors investigated associations between serum C-reactive protein (CRP) concentrations and colon andnrectal cancer risk in a nested case-control study within the European Prospective Investigation into Cancernand Nutrition (1992–2003) among 1,096 incident cases and 1,096 controls selected using risk-set sampling andnmatched on study center, age, sex, time of blood collection, fasting status, menopausal status, menstrual cyclenphase, and hormone replacement therapy. In conditional logistic regression with adjustment for education, smoking,nnutritional factors, body mass index, and waist circumference, CRP showed a significant nonlinear associationnwith colon cancer risk but not rectal cancer risk. Multivariable-adjusted relative risks for CRP concentrations of u00013.0nmg/L versus <1.0 mg/L were 1.36 (95% confidence interval (CI): 1.00, 1.85; P-trend ?0.01) for colon cancer andn1.02 (95% CI: 0.67, 1.57; P-trend ?0.65) for rectal cancer. Colon cancer risk was significantly increased in menn(relative risk ?1.74, 95% CI: 1.11, 2.73; P-trend ?0.01) but not in women (relative risk ?1.06, 95% CI: 0.67, 1.68;nP-trend ?0.13). Additional adjustment for C-peptide, glycated hemoglobin, and high density lipoprotein cholesterolndid not attenuate these results. These data provide evidence that elevated CRP concentrations are related tona higher risk of colon cancer but not rectal cancer, predominantly among men and independently of obesity, insulinnresistance, and dyslipidemia.