Chronic inflammation and risk of colorectal and other obesity‐related cancers: The health, aging and body composition study

Author:

Izano Monika12,Wei Esther K.3,Tai Caroline1,Swede Helen4,Gregorich Steven5,Harris Tamara B.6,Klepin Heidi7,Satterfield Suzanne8,Murphy Rachel6,Newman Anne B.9,Rubin Susan M.1,Braithwaite Dejana110,

Affiliation:

1. Department of Epidemiology and Biostatistics University of California San Francisco CA

2. School of Public Health University of California Berkeley CA

3. California Pacific Medical Center Research Institute San Francisco CA

4. Department of Community Medicine & Health Care University of Connecticut Health Center Farmington CT

5. Division of General Internal Medicine University of California San Francisco CA

6. National Institutes of Health, National Institute on Aging, National Institutes of Health Bethesda MD

7. Wake Forest School of Medicine Winston‐Salem NC

8. Department of Preventive Medicine University of Tennessee Health Science Center Memphis TN

9. Department of Epidemiology University of Pittsburgh Pittsburgh PN

10. Helen Diller Family Comprehensive Cancer Center, University of California San Francisco CA

Abstract

Evidence of the association between chronic inflammation and the risk of colorectal cancer (CRC) and other obesity‐related cancers (OBRC) remains inconsistent, possibly due to a paucity of studies examining repeated measures of inflammation. In the Health ABC prospective study of 2,490 adults aged 70–79 years at baseline, we assessed whether circulating levels of three markers of systemic inflammation, IL‐6, CRP and TNF‐α, were associated with the risk of CRC and OBRC, a cluster including cancers of pancreas, prostate, breast and endometrium. Inflammatory markers were measured in stored fasting blood samples. While only baseline measures of TNF‐α were available, IL‐6 and CRP were additionally measured at Years 2, 4, 6 and 8. Multivariable Cox models were fit to determine whether tertiles and log‐transformed baseline, updated and averaged measures of CRP and IL‐6 and baseline measures of TNF‐α were associated with the risk of incident cancer(s). During a median follow‐up of 11.9 years, we observed 55 and 172 cases of CRC and OBRC, respectively. The hazard of CRC in the highest tertile of updated CRP was more than double that in the lowest tertile (HR = 2.29; 95% CI: 1.08–4.86). No significant associations were seen between colorectal cancer and IL‐6 or TNF‐α. Additionally, no significant associations were found between obesity‐related cancers and the three inflammatory markers overall, but we observed a suggestion of effect modification by BMI and NSAID use. In summary, in this population, higher CRP levels were associated with increased risk of CRC, but not of OBRC. The findings provide new evidence that chronically elevated levels of CRP, as reflected by repeated measures of this marker, may play a role in colorectal carcinogenesis in older adults.

Funder

National Institute on Aging

National Institutes of Health

National Institute of Nursing Research

Publisher

Wiley

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