The EPIC-Norfolk Study
Pre-diagnostic C-reactive protein concentrations, CRP genetic variation and mortality among individuals with colorectal cancer in Western European populations.
BMC cancer 2021 ; 22: 695.
Nimptsch K, Aleksandrova K, Fedirko V, Jenab M, Gunter MJ, Siersema PD, Wu K, Katzke V, Kaaks R, Panico S, Palli D, May AM, Sieri S, Bueno-de-Mesquita B, Standahl K, Sánchez MJ, Perez-Cornago A, Olsen A, Tjønneland A, Bonet CB, Dahm CC, Chirlaque MD, Fiano V, Tumino R, Gurrea AB, Boutron-Ruault MC, Menegaux F, Severi G, Van Guelpen B, Lee YA, and Pischon T
DOI : 10.1186/s12885-022-09778-9
PubMed ID : 35739525
PMCID :
URL : https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09778-9
Abstract
The role of elevated pre-diagnostic C-reactive protein (CRP) concentrations on mortality in individuals with colorectal cancer (CRC) remains unclear.
We investigated the association between pre-diagnostic high-sensitivity CRP concentrations and CRP genetic variation associated with circulating CRP and CRC-specific and all-cause mortality based on data from 1,235 individuals with CRC within the European Prospective Investigation into Cancer and Nutrition cohort using multivariable-adjusted Cox proportional hazards regression.
During a median follow-up of 9.3 years, 455 CRC-specific deaths were recorded, out of 590 deaths from all causes. Pre-diagnostic CRP concentrations were not associated with CRC-specific (hazard ratio, HR highest versus lowest quintile 0.92, 95% confidence interval, CI 0.66, 1.28) or all-cause mortality (HR 0.91, 95% CI 0.68, 1.21). Genetic predisposition to higher CRP (weighted score based on alleles of four CRP SNPs associated with higher circulating CRP) was not significantly associated with CRC-specific mortality (HR per CRP-score unit 0.95, 95% CI 0.86, 1.05) or all-cause mortality (HR 0.98, 95% CI 0.90, 1.07). Among four investigated CRP genetic variants, only SNP rs1205 was significantly associated with CRC-specific (comparing the CT and CC genotypes with TT genotype, HR 0.54, 95% CI 0.35, 0.83 and HR 0.58, 95% CI 0.38, 0.88, respectively) and all-cause mortality (HR 0.58, 95% CI 0.40, 0.85 and 0.64, 95% CI 0.44, 0.92, respectively).
The results of this prospective cohort study do not support a role of pre-diagnostic CRP concentrations on mortality in individuals with CRC. The observed associations with rs1205 deserve further scientific attention.