C-reactive Protein and Colorectal Cancer Mortality in US Adults
Menée aux Etats-Unis à partir des données de la cohorte "NHANES III" incluant 15 924 participants, cette étude évalue l'association entre le niveau sérique de la protéine C-réactive avant un diagnostic de cancer colorectal et la mortalité des patients
Background: Chronic inflammation has been associated with colorectal cancer (CRC). Pre-diagnostic levels of C-reactive protein (CRP), a highly sensitive marker of inflammation, have been weakly associated with increased CRC incidence; but few data are available examining its relationship with CRC mortality.
Methods: In the Third National Health and Nutrition Examination Survey (NHANES III), 65% of the 15,924 adult participants had CRP levels ≤0.21mg/dL. Using this as the reference group, we calculated hazard ratios (HRs) for higher CRP categories and CRC mortality, and compared them with HRs for other mortality causes.
Results: Over a median follow-up period of 14.2 years, there were 92 deaths from colorectal cancer. Compared with the reference group, multivariable adjusted HRs for CRC mortality were 2.66 (95% CI: 1.36-5.20) for CRP levels 0.22-0.50 mg/dL; 3.40 (95% CI: 1.48-7.77) for levels 0.51-1.00 mg/dL; and 3.96 (95% CI: 1.64-9.52) for levels >1.00 mg/dL. Estimates for CRC mortality did not change appreciably after excluding deaths within the first 3 years or by limiting follow-up to 5 or 10 years.
Conclusions: In a large representative study of US adults, we observed strong dose-response associations between CRP levels and CRC mortality.
Impact: Further evaluation of CRP may help identify high risk groups for CRC screening and those who might benefit most from prophylactic anti-inflammatory therapy.
Cancer Epidemiology Biomarkers & Prevention , résumé, 2014