Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 172, Issue 4, Pages 407-418Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwq135
Keywords
colorectal neoplasms; C-reactive protein; hyperglycemia; hyperinsulinism; hyperlipidemias; inflammation; obesity; abdominal
Categories
Funding
- European Commission
- Ligue Contre le Cancer, France
- Institut Gustave Roussy, France
- Mutuelle Generale de l'Education Nationale, France
- Institut National de la Sante et de la Recherche Medicale, France
- German Cancer Aid, Germany
- Federal Ministry of Education and Research, Germany
- Danish Cancer Society, Denmark
- European Commission, Denmark [FP6-FOOD-CT-2006-016279]
- Spanish Ministry of Health and participating regional governments and institutions (Spain)
- Cancer Research UK
- Stroke Association, United Kingdom
- British Heart Foundation, United Kingdom
- United Kingdom Department of Health, United Kingdom
- United Kingdom Food Standards Agency, United Kingdom
- Wellcome Trust (United Kingdom)
- Greek Ministry of Health, Greece
- Stavros Niarchos Foundation, Greece
- Hellenic Health Foundation (Greece)
- Italian Association for Research on Cancer, Italy
- Dutch Ministry of Public Health, Welfare and Sports
- Netherlands Cancer Registry
- German Cancer Research Center
- Medical Research Council
- Italian National Research Council (Italy)
- LK Research Funds
- Dutch Prevention Funds
- Dutch ZON (Zorg Onderzoek Nederland)
- World Cancer Research Fund (the Netherlands)
- Swedish Cancer Society, Sweden
- Swedish Scientific Council, Sweden
- Regional Government of Skane (Sweden)
- Norwegian Cancer Society (Norway)
- Medical Research Council [MC_U106179471, G0401527] Funding Source: researchfish
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The authors investigated associations between serum C-reactive protein (CRP) concentrations and colon and rectal cancer risk in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (1992-2003) among 1,096 incident cases and 1,096 controls selected using risk-set sampling and matched on study center, age, sex, time of blood collection, fasting status, menopausal status, menstrual cycle phase, and hormone replacement therapy. In conditional logistic regression with adjustment for education, smoking, nutritional factors, body mass index, and waist circumference, CRP showed a significant nonlinear association with colon cancer risk but not rectal cancer risk. Multivariable-adjusted relative risks for CRP concentrations of >= 3.0 mg/L versus < 1.0 mg/L were 1.36 (95% confidence interval (CI): 1.00, 1.85; P-trend = 0.01) for colon cancer and 1.02 (95% CI: 0.67, 1.57; P-trend = 0.65) for rectal cancer. Colon cancer risk was significantly increased in men (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; P-trend = 0.13). Additional adjustment for C-peptide, glycated hemoglobin, and high density lipoprotein cholesterol did not attenuate these results. These data provide evidence that elevated CRP concentrations are related to a higher risk of colon cancer but not rectal cancer, predominantly among men and independently of obesity, insulin resistance, and dyslipidemia.
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