title: C-reactive protein concentrations and subsequent ovarian cancer risk.
abstract: OBJECTIVE
  To estimate the association between prediagnostic levels of C-reactive protein (CRP), a marker of chronic systemic inflammation, and subsequent development of ovarian cancer.
  
  
  METHODS
  A multicenter, nested, case-control study was conducted, including women who developed ovarian cancer (case patients) and women who were cancer-free (controls) from the following cohorts: CLUE ("Give us a CLUE to cancer and heart disease") cohorts of Washington County, Maryland, the Columbia, Missouri Serum Bank, and the Island of Guernsey Prospective Study, United Kingdom. A total of 167 incident invasive epithelial ovarian cancer cases were identified and each matched to an average of two controls on cohort, age, race, menopausal status, time since last menstrual period, current hormone use, date of recruitment, and time of day of blood draw. Baseline serum samples were assayed for CRP concentrations, and estimates of risk associated with CRP levels were assessed using conditional logistic regression.
  
  
  RESULTS
  Ovarian cancer risk was positively associated with increasing CRP concentrations. The risk of developing ovarian cancer among women in the highest third of the distribution of CRP compared with those in the lowest third was 1.72 (95% confidence interval 1.06-2.77), with evidence of an increasing risk with increasing concentration of CRP (P trend=0.02). Similar associations were observed using established clinical CRP cutpoints for heart disease risk (odds ratio 2.03, 95% confidence interval 1.20-3.47 for 3-10 mg/L compared with less than 1 mg/L, P trend=.008). If this association is causal, roughly 23% of ovarian cancer cases are attributed to chronic inflammation as indicated by elevated CRP concentrations.
  
  
  CONCLUSIONS
  Higher circulating CRP concentrations in women who subsequently developed ovarian cancer support the hypothesized role of chronic inflammation in ovarian carcinogenesis.
  
  
  METHODS
  II.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21202, USA, and Academic Oncology Unit, Guy's Hospital, London, United Kingdom.
authors.forename: Meghan A
authors.initials: MA
authors.lastname: McSorley
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Alberg
authors.forename: Diane S
authors.initials: DS
authors.lastname: Allen
authors.forename: Naomi E
authors.initials: NE
authors.lastname: Allen
authors.forename: Louise A
authors.initials: LA
authors.lastname: Brinton
authors.forename: Joanne F
authors.initials: JF
authors.lastname: Dorgan
authors.forename: Michael
authors.initials: M
authors.lastname: Pollak
authors.forename: Yuzhen
authors.initials: Y
authors.lastname: Tao
authors.forename: Kathy J
authors.initials: KJ
authors.lastname: Helzlsouer
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein