C-reactive protein and ovarian cancer: a prospective study nested in three cohorts (Sweden, USA, Italy).
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.
Lundin
Eva
E
Department of Medical Biosciences, Umeå University, Umeå, Sweden.
Dossus
Laure
L
Clendenen
Tess
T
Krogh
Vittorio
V
Grankvist
Kjell
K
Wulff
Marianne
M
Sieri
Sabina
S
Arslan
Alan A
AA
Lenner
Per
P
Berrino
Franco
F
Hallmans
Goran
G
Zeleniuch-Jacquotte
Anne
A
Toniolo
Paolo
P
Lukanova
Annekatrin
A
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
D015415:Biomarkers; D002097:C-Reactive Protein