A prospective evaluation of C-reactive protein levels and colorectal adenoma development

Marc J. Gunter, Amanda J. Cross, Wen Yi Huang, Frank Z. Stanczyk, Mark Purdue, Xiaonan (Nan) Xue, Robert Schoen, Paul J. Limburg, Arthur Schatzkin, Rashmi Sinha, Richard B. Hayes

Research output: Contribution to journalArticle

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Abstract

Background: Inflammation is hypothesized to play a role in colorectal tumorigenesis. Circulating levels of C-reactive protein (CRP), a serologic marker of the inflammatory response, have been positively associated with colorectal cancer development in some studies; however, there are limited data on the relation of CRP with colorectal adenomas, established precursors of colorectal cancer. Methods: A nested case - control investigation of CRP levels and incident colorectal adenoma was conducted in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, a randomized trial of 154,942 individuals designed to test the efficacy of flexible sigmoidoscopy on colorectal cancer mortality when performed once, and then repeated 3 to 5 years later. Serum CRP levels were measured in baseline blood specimens from participants who were free of polyps in the left-sided colorectum at the baseline screening procedure, but who were found at the subsequent screen to have at least one colorectal adenoma (n = 356), and in a set of polyp-free, frequency-matched controls (n = 396). Results: In a multivariable logistic regression model that included established colorectal adenoma risk factors, a 1-unit increase in log CRP level was associated with a 15% reduction in risk of developing colorectal adenoma (OR = 0.85, 95% CI, 0.75-0.98, Ptrend = 0.01). This association did not differ according to body size, smoking behavior, gender, use of nonsteroidal antiinflammatory drugs, or adenoma location. Conclusions: High circulating CRP levels may be protective against colorectal adenoma development. Impact: Though at contrast with mechanistic data on inflammation and colorectal tumorigenesis, this finding is not inconsistent with prior results on CRP and colorectal adenoma and warrants further investigation.

Original languageEnglish (US)
Pages (from-to)537-544
Number of pages8
JournalCancer Epidemiology Biomarkers and Prevention
Volume20
Issue number3
DOIs
StatePublished - Mar 2011

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Adenoma
C-Reactive Protein
Colorectal Neoplasms
Polyps
Carcinogenesis
Logistic Models
Inflammation
Sigmoidoscopy
Body Size
Risk Reduction Behavior
Early Detection of Cancer
Ovarian Neoplasms
Blood Proteins
Lung Neoplasms
Prostatic Neoplasms
Anti-Inflammatory Agents
Smoking
Mortality
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

A prospective evaluation of C-reactive protein levels and colorectal adenoma development. / Gunter, Marc J.; Cross, Amanda J.; Huang, Wen Yi; Stanczyk, Frank Z.; Purdue, Mark; Xue, Xiaonan (Nan); Schoen, Robert; Limburg, Paul J.; Schatzkin, Arthur; Sinha, Rashmi; Hayes, Richard B.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 20, No. 3, 03.2011, p. 537-544.

Research output: Contribution to journalArticle

Gunter, MJ, Cross, AJ, Huang, WY, Stanczyk, FZ, Purdue, M, Xue, XN, Schoen, R, Limburg, PJ, Schatzkin, A, Sinha, R & Hayes, RB 2011, 'A prospective evaluation of C-reactive protein levels and colorectal adenoma development', Cancer Epidemiology Biomarkers and Prevention, vol. 20, no. 3, pp. 537-544. https://doi.org/10.1158/1055-9965.EPI-10-1099
Gunter, Marc J. ; Cross, Amanda J. ; Huang, Wen Yi ; Stanczyk, Frank Z. ; Purdue, Mark ; Xue, Xiaonan (Nan) ; Schoen, Robert ; Limburg, Paul J. ; Schatzkin, Arthur ; Sinha, Rashmi ; Hayes, Richard B. / A prospective evaluation of C-reactive protein levels and colorectal adenoma development. In: Cancer Epidemiology Biomarkers and Prevention. 2011 ; Vol. 20, No. 3. pp. 537-544.
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abstract = "Background: Inflammation is hypothesized to play a role in colorectal tumorigenesis. Circulating levels of C-reactive protein (CRP), a serologic marker of the inflammatory response, have been positively associated with colorectal cancer development in some studies; however, there are limited data on the relation of CRP with colorectal adenomas, established precursors of colorectal cancer. Methods: A nested case - control investigation of CRP levels and incident colorectal adenoma was conducted in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, a randomized trial of 154,942 individuals designed to test the efficacy of flexible sigmoidoscopy on colorectal cancer mortality when performed once, and then repeated 3 to 5 years later. Serum CRP levels were measured in baseline blood specimens from participants who were free of polyps in the left-sided colorectum at the baseline screening procedure, but who were found at the subsequent screen to have at least one colorectal adenoma (n = 356), and in a set of polyp-free, frequency-matched controls (n = 396). Results: In a multivariable logistic regression model that included established colorectal adenoma risk factors, a 1-unit increase in log CRP level was associated with a 15{\%} reduction in risk of developing colorectal adenoma (OR = 0.85, 95{\%} CI, 0.75-0.98, Ptrend = 0.01). This association did not differ according to body size, smoking behavior, gender, use of nonsteroidal antiinflammatory drugs, or adenoma location. Conclusions: High circulating CRP levels may be protective against colorectal adenoma development. Impact: Though at contrast with mechanistic data on inflammation and colorectal tumorigenesis, this finding is not inconsistent with prior results on CRP and colorectal adenoma and warrants further investigation.",
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AU - Gunter, Marc J.

AU - Cross, Amanda J.

AU - Huang, Wen Yi

AU - Stanczyk, Frank Z.

AU - Purdue, Mark

AU - Xue, Xiaonan (Nan)

AU - Schoen, Robert

AU - Limburg, Paul J.

AU - Schatzkin, Arthur

AU - Sinha, Rashmi

AU - Hayes, Richard B.

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N2 - Background: Inflammation is hypothesized to play a role in colorectal tumorigenesis. Circulating levels of C-reactive protein (CRP), a serologic marker of the inflammatory response, have been positively associated with colorectal cancer development in some studies; however, there are limited data on the relation of CRP with colorectal adenomas, established precursors of colorectal cancer. Methods: A nested case - control investigation of CRP levels and incident colorectal adenoma was conducted in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, a randomized trial of 154,942 individuals designed to test the efficacy of flexible sigmoidoscopy on colorectal cancer mortality when performed once, and then repeated 3 to 5 years later. Serum CRP levels were measured in baseline blood specimens from participants who were free of polyps in the left-sided colorectum at the baseline screening procedure, but who were found at the subsequent screen to have at least one colorectal adenoma (n = 356), and in a set of polyp-free, frequency-matched controls (n = 396). Results: In a multivariable logistic regression model that included established colorectal adenoma risk factors, a 1-unit increase in log CRP level was associated with a 15% reduction in risk of developing colorectal adenoma (OR = 0.85, 95% CI, 0.75-0.98, Ptrend = 0.01). This association did not differ according to body size, smoking behavior, gender, use of nonsteroidal antiinflammatory drugs, or adenoma location. Conclusions: High circulating CRP levels may be protective against colorectal adenoma development. Impact: Though at contrast with mechanistic data on inflammation and colorectal tumorigenesis, this finding is not inconsistent with prior results on CRP and colorectal adenoma and warrants further investigation.

AB - Background: Inflammation is hypothesized to play a role in colorectal tumorigenesis. Circulating levels of C-reactive protein (CRP), a serologic marker of the inflammatory response, have been positively associated with colorectal cancer development in some studies; however, there are limited data on the relation of CRP with colorectal adenomas, established precursors of colorectal cancer. Methods: A nested case - control investigation of CRP levels and incident colorectal adenoma was conducted in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, a randomized trial of 154,942 individuals designed to test the efficacy of flexible sigmoidoscopy on colorectal cancer mortality when performed once, and then repeated 3 to 5 years later. Serum CRP levels were measured in baseline blood specimens from participants who were free of polyps in the left-sided colorectum at the baseline screening procedure, but who were found at the subsequent screen to have at least one colorectal adenoma (n = 356), and in a set of polyp-free, frequency-matched controls (n = 396). Results: In a multivariable logistic regression model that included established colorectal adenoma risk factors, a 1-unit increase in log CRP level was associated with a 15% reduction in risk of developing colorectal adenoma (OR = 0.85, 95% CI, 0.75-0.98, Ptrend = 0.01). This association did not differ according to body size, smoking behavior, gender, use of nonsteroidal antiinflammatory drugs, or adenoma location. Conclusions: High circulating CRP levels may be protective against colorectal adenoma development. Impact: Though at contrast with mechanistic data on inflammation and colorectal tumorigenesis, this finding is not inconsistent with prior results on CRP and colorectal adenoma and warrants further investigation.

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