Serum bilirubin and colorectal cancer risk: a population-based cohort study

Background Bilirubin has antioxidant properties and has been postulated to protect against the development of malignancies. Aim To investigate whether baseline serum bilirubin concentration predicts the incidence of colorectal cancer in a nationally representative sample of the US population. Methods Participants of the first National Health and Nutrition Examination Survey were divided into four groups based on quartiles of baseline serum bilirubin concentration in mg/dL: < 0.38 (n = 1410), 0.38 to < 0.5 (n = 1287), 0.5 to < 0.6 (n = 1048) and >= 0.6 (n = 1742). The incidence of colorectal cancer during the following 20 years was determined from hospitalization records and death certificates. Results 110 cases of colorectal cancer-related death or hospitalization were identified among 5487 participants during 88 339 person-years of follow-up (12 per 10 000 person-years). There was no association between baseline serum bilirubin concentration and the incidence of colorectal cancer either in unadjusted analyses or after adjusting for age, gender, ethnicity, smoking, body mass index, alcohol consumption and educational attainment. Conclusions Baseline serum bilirubin concentration did not predict the subsequent incidence of colorectal cancer in this population-based cohort study.