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Elevated C-Reactive Protein Associated with Colon Cancer

Elevated CRP levels predict development of colon cancer, but not rectal cancer.

It is well known that colonic inflammatory bowel disease is associated with increased risk for colorectal cancer and that nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the risk for colorectal cancer. To examine whether inflammation is associated with colorectal cancer, researchers conducted a nested, case-control study of 22,887 adults in Washington County, Maryland.

Each participant provided a blood sample in 1989 and was followed until 2000. During follow-up, 172 new cases of colon or rectal cancer were identified. The mean C-reactive protein (CRP) level was higher among the 131 colon-cancer cases than among controls (2.78 mg/L vs. 1.98 mg/L; P=0.002). CRP levels did not differ significantly between rectal-cancer cases and controls. Use of aspirin or NSAIDs at baseline was associated with reduced risk for colorectal cancer (odds ratio, 0.63).

Comment: These results provide strong evidence that elevated CRP levels predict development of colon cancer, but not rectal cancer, and support a role for anti-inflammatory drugs in the prevention of colorectal cancer. We can hope that the study stimulates further research into the association between colon cancer and inflammation.

— Douglas K. Rex, MD

Published in Journal Watch Gastroenterology March 2, 2004

Citation(s):

Erlinger TP et al. C-reactive protein and the risk of incident colorectal cancer. JAMA 2004 Feb 4; 291:585-90.

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