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

3 Citations (Scopus)

Abstract

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
Volume26
Issue number7
DOIs
StatePublished - Jul 1 2017

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Women's Health
C-Reactive Protein
Biomarkers
Breast Neoplasms
Mortality
Incidence
Proteins
Body Mass Index
Confidence Intervals
Survival
Proportional Hazards Models
Case-Control Studies

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

The association of the c-reactive protein inflammatory biomarker with breast cancer incidence and mortality in the women's health initiative. / Nelson, Sandahl H.; Brasky, Theodore M.; Patterson, Ruth E.; Laughlin, Gail A.; Kritz-Silverstein, Donna; Edwards, Beatrice J.; Lane, Dorothy; Rohan, Thomas E.; Ho, Gloria Y.F.; Manson, Joann E.; LaCroix, Andrea Z.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 26, No. 7, 01.07.2017, p. 1100-1106.

Research output: Contribution to journalArticle

Nelson, SH, Brasky, TM, Patterson, RE, Laughlin, GA, Kritz-Silverstein, D, Edwards, BJ, Lane, D, Rohan, TE, Ho, GYF, Manson, JE & LaCroix, AZ 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, vol. 26, no. 7, pp. 1100-1106. https://doi.org/10.1158/1055-9965.EPI-16-1005
Nelson, Sandahl H. ; Brasky, Theodore M. ; Patterson, Ruth E. ; Laughlin, Gail A. ; Kritz-Silverstein, Donna ; Edwards, Beatrice J. ; Lane, Dorothy ; Rohan, Thomas E. ; Ho, Gloria Y.F. ; Manson, Joann E. ; LaCroix, Andrea Z. / The association of the c-reactive protein inflammatory biomarker with breast cancer incidence and mortality in the women's health initiative. In: Cancer Epidemiology Biomarkers and Prevention. 2017 ; Vol. 26, No. 7. pp. 1100-1106.
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abstract = "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.",
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T1 - The association of the c-reactive protein inflammatory biomarker with breast cancer incidence and mortality in the women's health initiative

AU - Nelson, Sandahl H.

AU - Brasky, Theodore M.

AU - Patterson, Ruth E.

AU - Laughlin, Gail A.

AU - Kritz-Silverstein, Donna

AU - Edwards, Beatrice J.

AU - Lane, Dorothy

AU - Rohan, Thomas E.

AU - Ho, Gloria Y.F.

AU - Manson, Joann E.

AU - LaCroix, Andrea Z.

PY - 2017/7/1

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N2 - 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.

AB - 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.

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