The association between C-reactive protein concentrations and development of colon cancer

Chronic systemic inflammation may be a significant component of several disease processes, especially heart disease and cancer.   Serum C-reactive protein (CRP) concentration is a marker of the inflammatory response.   CRP is an acute-phase reactant produced in the liver in response to interleukin-6  (IL-6).   A growing body of literature supports an association between CRP levels and risk of cardiovascular disease.  An increased risk of heart disease has been observed with levels in the range of 2 to 3 mg/L, levels that previously were considered to be in the “normal” range. 

Prospective studies nested within long-term cohort studies have examined the association between CRP levels and subsequent development of cancer.  The CLUE Cohort studies (CLUE I and CLUE II) were established in Washington County, Maryland in 1974 and 1989, respectively.  Participants in the studies have been followed for the development of cancer using County and State cancer registries.  Two nested case-control studies were conducted using pre-diagnostic serum to test the association between CRP and the development of colorectal or prostate cancer. 

Pre-diagnostic CRP concentrations were higher among individuals who subsequently developed colon cancer compared to controls.  No association was observed between baseline CRP concentrations and the development or prostate or rectal cancer. 

The observed association between CRP, a marker of inflammation,  and colon cancer is consistent with other evidence suggesting a strong role of inflammation and colon carcinogenesis.   Intervention that decrease systemic inflammation have the potential to reduce colon cancer as well as cardiovascular disease.   Recent experience with certain types of anti-inflammatory agents such as Cox-2 inhibitors demonstrate the need for well-designed trials to assess the potential benefits for prevention as well as the risks associated with these interventions. 

Bibliographical reference:

Helzlsouer KJ et al.: "C-reactive protein levels and subsequent cancer outcomes: Results from a prospective cohort study", Eur J Cancer. 2006 Apr;42(6):704-707 

Kathy J. Helzlsouer