title: C-reactive protein and ovarian cancer: a prospective study nested in three cohorts (Sweden, USA, Italy).
abstract: OBJECTIVE
  Inflammatory processes may influence the risk of epithelial ovarian cancer, but available epidemiological evidence is limited and indirect. Circulating C-reactive protein (CRP), a sensitive marker of inflammation, may serve as a direct biological marker of an underlying association.
  
  
  METHODS
  The association between ovarian cancer risk and pre-diagnostic circulating CRP was tested in a case-control study nested within three prospective cohorts from Sweden, USA, and Italy. The study included 237 cases and 427 individually matched controls. CRP was measured in stored blood samples by high-sensitivity immunoturbidimetric assay. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by conditional logistic regression.
  
  
  RESULTS
  Overall, CRP was not related to risk of ovarian cancer. However, a marked increase in risk was observed for CRP concentrations >10 mg/l: OR (95% CI) 4.4 (1.8-10.9), which remained significant after limiting analyses to cases diagnosed more than two or five years after blood donation (OR 3.0 (1.2-8.0) and 3.6 (1.0-13.2), respectively). Risk of mucinous tumors increased with high CRP, but the number of cases in this analysis was small.
  
  
  CONCLUSIONS
  Study results offer additional support to the concept that chronic inflammation plays a role in epithelial ovarian cancer.
authors.affiliation: Department of Medical Biosciences, Umeå University, Umeå, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Lundin
authors.forename: Laure
authors.initials: L
authors.lastname: Dossus
authors.forename: Tess
authors.initials: T
authors.lastname: Clendenen
authors.forename: Vittorio
authors.initials: V
authors.lastname: Krogh
authors.forename: Kjell
authors.initials: K
authors.lastname: Grankvist
authors.forename: Marianne
authors.initials: M
authors.lastname: Wulff
authors.forename: Sabina
authors.initials: S
authors.lastname: Sieri
authors.forename: Alan A
authors.initials: AA
authors.lastname: Arslan
authors.forename: Per
authors.initials: P
authors.lastname: Lenner
authors.forename: Franco
authors.initials: F
authors.lastname: Berrino
authors.forename: Goran
authors.initials: G
authors.lastname: Hallmans
authors.forename: Anne
authors.initials: A
authors.lastname: Zeleniuch-Jacquotte
authors.forename: Paolo
authors.initials: P
authors.lastname: Toniolo
authors.forename: Annekatrin
authors.initials: A
authors.lastname: Lukanova
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications*; D007558:Italy / Q000453:epidemiology; D010051:Ovarian Neoplasms / Q000145:classification / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein