The association of the c-reactive protein inflammatory biomarker with breast cancer incidence and mortality in the women's health initiative

Sandahl H. Nelson, Theodore M. Brasky, Ruth E. Patterson, Gail A. Laughlin, Donna Kritz-Silverstein, Beatrice J. Edwards, Dorothy Lane, Thomas E. Rohan, Gloria Y.F. Ho, Joann E. Manson, Andrea Z. LaCroix

Research output: Contribution to journalArticle

4 Scopus citations


Purpose: To examine associations of prediagnosis highsensitivity C-reactive protein (hsCRP) with breast cancer incidence and postdiagnosis survival and to assess whether associations are modified by body mass index (BMI). Methods: A prospective analysis of the Women's Health Initiative was conducted among 17,841 cancer-free postmenopausal women with baseline hsCRP measurements. Cox proportional hazards models were used to examine associations between hsCRP concentrations and (i) breast cancer risk (n cases 1,114) and (ii) all-cause mortality after breast cancer diagnosis. HRs are per 1 SD in log hsCRP. Results: hsCRP was not associated with breast cancer risk overall [HR 1.05; 95% confidence interval (CI), 0.98-1.12]; however, an interaction between BMI and hsCRP was observed (Pinteraction 0.02). A 1 SD increase in log hsCRP was associated with 17% increased breast cancer risk (HR 1.17; 95% CI, 1.03-1.33) among lean women (BMI < 25), whereas no association was observed among overweight/obese (BMI 25) women. Prediagnosis hsCRP was not associated with overall mortality (HR, 1.04; 95% CI, 0.88-1.21) after breast cancer diagnosis; however, an increased mortality risk was apparent among leaner women with higher hsCRP levels (HR, 1.39, 95% CI, 1.03-1.88). Conclusions: Prediagnosis hsCRP levels are not associated with postmenopausal breast cancer incidence or survival overall; however, increased risks are suggested among leaner women. The observed effect modification is in the opposite direction of a previous case-control study finding and warrants further investigation. Impact: Associations of higher CRP levels with incident breast cancer and survival after breast cancer may depend on BMI.

Original languageEnglish (US)
Pages (from-to)1100-1106
Number of pages7
JournalCancer Epidemiology Biomarkers and Prevention
Issue number7
StatePublished - Jul 1 2017


ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Nelson, S. H., Brasky, T. M., Patterson, R. E., Laughlin, G. A., Kritz-Silverstein, D., Edwards, B. J., Lane, D., Rohan, T. E., Ho, G. Y. F., Manson, J. E., & LaCroix, A. Z. (2017). The association of the c-reactive protein inflammatory biomarker with breast cancer incidence and mortality in the women's health initiative. Cancer Epidemiology Biomarkers and Prevention, 26(7), 1100-1106.