title: Changes in pre-diagnostic serum C-reactive protein concentrations and ovarian cancer risk: a longitudinal study.
abstract: BACKGROUND
  Evidence suggests that inflammation may be associated with increased risk of ovarian cancer but there is paucity of studies investigating this association, especially using over-time changes in inflammatory biomarkers.
  
  
  METHODS
  We conducted a prospective population-based case-control study nested within the Finnish Maternity Cohort (FMC). Within the FMC, 170 women with ovarian cancer who had donated serum samples to the cohort twice, ≥1 year apart, before cancer diagnoses were identified. One control per case was matched for age, parity and sampling date.
  
  
  RESULTS
  Comparing the highest with lowest tertiles, the odds ratio (OR) of ovarian cancer using the first set of serum samples (mean lag time to cancer diagnosis 9.0 years) was 1.62 [95% confidence interval (CI) 0.93-2.83]. However, analysis conducted using the second set of serum samples donated closer to cancer diagnosis (mean lag time 6.4 years) revealed a significantly increased risk of ovarian cancer comparing extreme tertiles of C-reactive protein (CRP) concentrations; OR 1.96 (95% CI 1.11-3.4). Over time, increases in individuals' CRP concentrations were also associated with increased risk; OR 1.90 (95% CI 1.12-3.23).
  
  
  CONCLUSIONS
  The results suggest that inflammation may precede ovarian cancer since increasing CRP concentrations, both across tertiles and longitudinally at the individual level, were associated with increased risk.
authors.affiliation: National Institute for Health and Welfare, Oulu, Finland. Adetunji.toriola@uta.fi
authors.forename: A T
authors.initials: AT
authors.lastname: Toriola
authors.forename: K
authors.initials: K
authors.lastname: Grankvist
authors.forename: C B
authors.initials: CB
authors.lastname: Agborsangaya
authors.forename: A
authors.initials: A
authors.lastname: Lukanova
authors.forename: M
authors.initials: M
authors.lastname: Lehtinen
authors.forename: H M
authors.initials: HM
authors.lastname: Surcel
mesh_terms: D000293:Adolescent; D000328:Adult; D018070:Biological Specimen Banks; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D005260:Female; D005387:Finland; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology; D008137:Longitudinal Studies; D016017:Odds Ratio; D010051:Ovarian Neoplasms / Q000097:blood* / Q000453:epidemiology*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein