Abstract
BackgroundInflammation is associated with cancer but there are conflicting reports on associations of biomarkers of inflammation with cancer risk and mortality. We investigated the associations of C-reactive protein (CRP) and leukocyte count with cancer risk and mortality using individual biomarkers, and an inflammatory score derived from both biomarkers.MethodsWe conducted this analysis among 2,570 men enrolled in the population-based, prospective Kuopio Ischemic Heart Disease Risk Factor Study in Finland. During an average follow-up period of 26 years, 653 cancer cases and 287 cancer deaths occurred. We computed a z-score for each participant, with the combined z-score being the sum of each individual’s CRP and leukocyte z-scores. Multivariable-adjusted Cox proportional hazard model was used to evaluate associations with cancer risk and mortality.ResultsUsing individual biomarkers, elevated leukocyte count was associated with an increased risk of cancer (RR = 1.31, 95 % CI 1.04-1.66), and cancer mortality (RR=, 95 % CI 1.39, 0.98-1.97). The corresponding results for CRP were (RR = 1.23, 95 % CI 0.97-1.55) for risk and (RR = 1.15, 95 % CI 0.81-1.64) for cancer mortality. Associations of the biomarkers with cancer appeared to be more robust using the combined z-score. HRs comparing men within the highest z-score quartile to those within the lowest z-score quartiles were 1.47 (95 % CI 1.16-1.88, p-trend < 0.01) for cancer risk, and 1.48 (95 % CI 1.03-2.14, p-trend = 0.09) for cancer mortality.ConclusionOur study suggests that inflammation is associated with cancer risk and mortality, and combining inflammatory biomarkers into a score is a robust method of elucidating this association.
Highlights
Inflammation is associated with cancer but there are conflicting reports on associations of biomarkers of inflammation with cancer risk and mortality
To elucidate on the associations of inflammatory biomarkers with cancer, we investigated the associations of C-reactive protein (CRP) and leukocyte count with cancer risk and mortality independently, as well as using a derived biomarker z-score combining both biomarkers
There were positive associations between CRP, leukocyte count, and cancer risk, which were attenuated after adjustment for smoking (Table 2)
Summary
Inflammation is associated with cancer but there are conflicting reports on associations of biomarkers of inflammation with cancer risk and mortality. We investigated the associations of C-reactive protein (CRP) and leukocyte count with cancer risk and mortality using individual biomarkers, and an inflammatory score derived from both biomarkers. Inflammation is associated with cancer risk and mortality [1, 2]. Several cancer types arise from local inflammatory states. There are conflicting reports on the associations of biomarkers of systemic inflammation with overall cancer risk and mortality. Creactive protein and leukocyte counts are biomarkers of systemic inflammation that have been related to all-cause. Because the biomarkers are systemic, associations between individual biomarkers and cancer may not be always apparent. Combining inflammatory biomarkers using an inflammatory score may provide a more accurate
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