title: C-reactive protein; a potential marker of second cancer and cardiovascular disease in testicular cancer survivors?
abstract: BACKGROUND
  C-reactive protein (CRP) is a marker of cardiovascular disease (CVD). There is conflicting evidence regarding CRP as a marker of future cancer. We studied whether CRP predicts CVD and consecutive cancer in testicular cancer survivors (TCSs).
  
  
  METHODS
  During 1998-2001, 586 TCSs with a high sensitivity CRP ≤ 10 mg/L were identified median 11 (4-21) years after treatment (FU-1). A second follow-up survey (FU-2) was conducted median 8 (6-9) years after FU-1. At FU-2 we obtained information about post-FU-1 CVD (cardiovascular death, nonfatal myocardial infarction, stroke, revascularisation or heart failure). Information about post-FU-1 non-germ cell cancer and cardiovascular death in all patients were retrieved from the Cancer Registry of Norway.
  
  
  RESULTS
  After FU-1 31 (5.3%) of 586 patients developed non-germ cell cancer (excluding localised prostate cancer), while 28 (4.9%) developed CVD. Cox regression analyses showed that patients with CRP ≥1.5mg/L had 2.21 (95% CI 1.04-4.70) times higher risk of developing non-germ cell cancer and 2.79 (95% CI 1.22-6.34) times higher risk for CVD compared to patients with CRP <1.5mg/L at FU-1.
  
  
  CONCLUSIONS
  In long-term TCSs, CRP may serve as a potential marker of cardiovascular events and a second cancer.
authors.affiliation: Department of Cardiology, Faculty Division Rikshospitalet, University of Oslo, Oslo, Norway. torgeir.wethal@medisin.uio.no
authors.forename: T
authors.initials: T
authors.lastname: Wethal
authors.forename: H S
authors.initials: HS
authors.lastname: Haugnes
authors.forename: J
authors.initials: J
authors.lastname: Kjekshus
authors.forename: M C
authors.initials: MC
authors.lastname: Småstuen
authors.forename: T
authors.initials: T
authors.lastname: Ueland
authors.forename: P
authors.initials: P
authors.lastname: Aukrust
authors.forename: S D
authors.initials: SD
authors.lastname: Fosså
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis*; D012307:Risk Factors; D017741:Survivors; D013736:Testicular Neoplasms / Q000378:metabolism* / Q000628:therapy; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D002097:C-Reactive Protein