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Association of inflammatory markers with colorectal cancer incidence in the atherosclerosis risk in communities study.

ABSTRACT: BACKGROUND:Chronic inflammation has been implicated in the etiology of colorectal cancer (CRC), but epidemiologic findings on the association between circulating inflammatory markers and CRC risk are inconsistent. We hypothesized that increased concentrations of systemic inflammatory markers-white blood cell count (WBC), fibrinogen, von Willebrand factor (VWF), factor VIII (FVIII), and C-reactive protein (CRP)-and decreased albumin concentration would be associated with increased CRC risk in the Atherosclerosis Risk in Communities prospective cohort. METHODS:WBC, fibrinogen, VWF, FVIII, and albumin, measured in 1987-1989 in 13,414 men and women, were transformed to z-scores and summed up to construct a blood "inflammation z-score." Albumin was included with a negative sign, because its concentration decreases with greater inflammation. A total of 308 incident CRC cases were identified through 2006 in initially cancer-free participants. CRP was measured in 1996-1998 in 9,836 cancer-free people who developed 166 CRCs through 2006. Proportional hazard models were used to estimate the HR and 95% CI of CRC in relation to each individual marker and the inflammation z-score. RESULTS:After multivariate adjustment, for the highest versus lowest quartile, there was a statistically significant positive association of CRC risk with fibrinogen: HR = 1.50 (95% CI, 1.05-2.15), P = 0.03; inflammation z-score: HR = 1.65 (95% CI, 1.15-2.35), P = 0.01; and CRP: HR = 1.97 (95% CI, 1.13-3.43, P = 0.02. CONCLUSIONS:These findings indicate that greater levels of fibrinogen, CRP, and blood inflammation z-score are associated with increased CRC risk. IMPACT:The study provides further evidence that precancer inflammation may contribute to CRC etiology.

SUBMITTER: Prizment AE

PROVIDER: S-EPMC3169294 | biostudies-literature | 2011 Feb

REPOSITORIES: biostudies-literature

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Association of inflammatory markers with colorectal cancer incidence in the atherosclerosis risk in communities study.

Prizment Anna E AE Anderson Kristin E KE Visvanathan Kala K Folsom Aaron R AR

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20110107 2

<h4>Background</h4>Chronic inflammation has been implicated in the etiology of colorectal cancer (CRC), but epidemiologic findings on the association between circulating inflammatory markers and CRC risk are inconsistent. We hypothesized that increased concentrations of systemic inflammatory markers-white blood cell count (WBC), fibrinogen, von Willebrand factor (VWF), factor VIII (FVIII), and C-reactive protein (CRP)-and decreased albumin concentration would be associated with increased CRC ris ...[more]

PMID: 21217085

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Project description:ImportanceIschemic stroke is associated with increased risk of dementia, but the association of stroke severity and recurrence with risk of impaired cognition is not well known.ObjectiveTo examine the risk of dementia after incident ischemic stroke and assess how it differed by stroke severity and recurrence.Design, setting, and participantsThe Atherosclerosis Risk in Communities (ARIC) study is an ongoing prospective cohort of 15 792 community-dwelling individuals from 4 US states (Mississippi, Maryland, Minnesota, and North Carolina). Among them, 15 379 participants free of stroke and dementia at baseline (1987 to 1989) were monitored through 2019. Data were analyzed from April to October 2021. Associations between dementia and time-varying ischemic stroke incidence, frequency, and severity were studied across an average of 4.4 visits over a median follow-up of 25.5 years with Cox proportional hazards models adjusted for sociodemographic characteristics, apolipoprotein E, and vascular risk factors.ExposuresIncident and recurrent ischemic strokes were classified by expert review of hospital records, with severity defined by the National Institutes of Health Stroke Scale (NIHSS; minor, ≤5; mild, 6-10; moderate, 11-15; and severe, ≥16).Main outcomes and measuresDementia cases adjudicated through expert review of in-person evaluations, informant interviews, telephone assessments, hospitalization codes, and death certificates. In participants with stroke, dementia events in the first year after stroke were not counted.ResultsAt baseline, the mean (SD) age of participants was 54.1 (5.8) years, and 8485 of 15 379 participants (55.2%) were women. A total of 4110 participants (26.7%) were Black and 11 269 (73.3%) were White. A total of 1378 ischemic strokes (1155 incident) and 2860 dementia cases were diagnosed 1 year or more after incident stroke in participants with stroke, or at any point after baseline in participants without stroke, were identified through December 31, 2019. NIHSS scores were available for 1184 of 1378 ischemic strokes (85.9%). Risk of dementia increased with both the number and severity of strokes. Compared with no stroke, risk of dementia by adjusted hazard ratio was 1.76 (95% CI, 1.49-2.00) for 1 minor to mild stroke, 3.47 (95% CI, 2.23-5.40) for 1 moderate to severe stroke, 3.48 (95% CI, 2.54-4.76) for 2 or more minor to mild strokes, and 6.68 (95% CI, 3.77-11.83) for 2 or more moderate to severe strokes.Conclusions and relevanceIn this study, risk of dementia significantly increased after ischemic stroke, independent of vascular risk factors. Results suggest a dose-response association of stroke severity and recurrence with risk of dementia.

Dataset Information

Association of inflammatory markers with colorectal cancer incidence in the atherosclerosis risk in communities study.

Publications

Association of inflammatory markers with colorectal cancer incidence in the atherosclerosis risk in communities study.

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