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Title: A prospective evaluation of C-reactive protein levels and colorectal adenoma development.
Authors: Gunter MJ,  Cross AJ,  Huang WY,  Stanczyk FZ,  Purdue M,  Xue X,  Schoen R,  Limburg PJ,  Schatzkin A,  Sinha R,  Hayes RB
Journal: Cancer Epidemiol Biomarkers Prev
Date: 2011 Mar
Branches: NEB, OEEB
PubMed ID: 21212059
PMC ID: PMC3051036
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.