title: Serum bilirubin and colorectal cancer risk: a population-based cohort study.
abstract: BACKGROUND
  Bilirubin has antioxidant properties and has been postulated to protect against the development of malignancies.
  
  
  OBJECTIVE
  To investigate whether baseline serum bilirubin concentration predicts the incidence of colorectal cancer in a nationally representative sample of the US population.
  
  
  METHODS
  Participants of the first National Health and Nutrition Examination Survey were divided into four groups based on quartiles of baseline serum bilirubin concentration in mg/dL: <0.38 (n = 1410), 0.38 to <0.5 (n = 1287), 0.5 to <0.6 (n = 1048) and > or = 0.6 (n = 1742). The incidence of colorectal cancer during the following 20 years was determined from hospitalization records and death certificates.
  
  
  RESULTS
  110 cases of colorectal cancer-related death or hospitalization were identified among 5487 participants during 88,339 person-years of follow-up (12 per 10,000 person-years). There was no association between baseline serum bilirubin concentration and the incidence of colorectal cancer either in unadjusted analyses or after adjusting for age, gender, ethnicity, smoking, body mass index, alcohol consumption and educational attainment.
  
  
  CONCLUSIONS
  Baseline serum bilirubin concentration did not predict the subsequent incidence of colorectal cancer in this population-based cohort study.
authors.affiliation: Northwest Hepatitis C Resource Center, Veternas Affairs Puget Sound Health Care System, Gastroenterology, Seattle, WA 98108, USA. georgei@medicine.washington.edu
authors.forename: G N
authors.initials: GN
authors.lastname: Ioannou
authors.forename: I W
authors.initials: IW
authors.lastname: Liou
authors.forename: N S
authors.initials: NS
authors.lastname: Weiss
mesh_terms: D000328:Adult; D001663:Bilirubin / Q000097:blood*; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000097:blood* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D001663:Bilirubin