title: Cardiorespiratory fitness, C-reactive protein and lung cancer risk: A prospective population-based cohort study.
abstract: BACKGROUND
  Little is known about the joint impact of C-reactive protein (CRP) and cardiorespiratory fitness (CRF) in lung cancer risk. The aim of this study is to examine the joint impact of CRF and CRP in predicting lung cancer risk.
  
  
  METHODS
  A population-based cohort study of 2276 men with no history of cancer was carried out. Baseline measures of CRP and CRF were divided into median values and categorised. During an average follow-up of 21-years, 73 cases of lung cancer occurred.
  
  
  RESULTS
  In a multivariate model, men with the combination of high CRP (>50% 1.24 mg/l) and low CRF (maximal oxygen uptake (VO2max) < 50% 30.08 ml/kg/min) had a fourfold (relative risk (RR) 4.19 95% confidence interval (CI) 1.66-10.57, p < 0.01) risk of lung cancer as compared to the reference group of low CRP (<50% 1.24 mg/l) and high CRF (VO2max>50% 30.08 ml/kg/min). Furthermore, men categorised in high CRP and combined with either low/high CRF, had an increased risk for lung cancer as compared to reference group. In further separate independent analysis for CRP and CRF, lung cancer risk was threefold for high CRP (RR 3.22, 95% CI 1.44-7.20, p < 0.01) and low CRF (RR 3.15, 95% CI 1.27-7.78, p = 0.01) as compared to reference CRP (>2.38 mg/l) and CRF (>35.15 ml/kg/min).
  
  
  CONCLUSIONS
  In this study, the joint impact of CRP and CRF is a strong risk marker for lung cancer. Furthermore, men with an increase in CRP were at higher risk for lung cancer than men with low CRP and high CRF may reduce the risk.
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland. Electronic address: paul.pletnikoff@uef.fi.
authors.forename: Perfenia Paul
authors.initials: PP
authors.lastname: Pletnikoff
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland; Lapland Central Hospital, Department of Internal Medicine, Rovaniemi, Finland. Electronic address: jariantero.laukkanen@uef.fi.
authors.forename: Jari A
authors.initials: JA
authors.lastname: Laukkanen
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland. Electronic address: tomi-pekka.tuomainen@uef.fi.
authors.forename: Tomi-Pekka
authors.initials: TP
authors.lastname: Tuomainen
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland. Electronic address: jussi.kauhanen@uef.fi.
authors.forename: Jussi
authors.initials: J
authors.lastname: Kauhanen
authors.affiliation: Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland. Electronic address: rainer.rauramaa@uef.fi.
authors.forename: Rainer
authors.initials: R
authors.lastname: Rauramaa
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland. Electronic address: kimmo.ronkainen@uef.fi.
authors.forename: Kimmo
authors.initials: K
authors.lastname: Ronkainen
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland; Lapland Central Hospital, Department of Internal Medicine, Rovaniemi, Finland. Electronic address: sudhir.kurl@uef.fi.
authors.forename: Sudhir
authors.initials: S
authors.lastname: Kurl
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology; D002320:Cardiovascular Physiological Phenomena; D015331:Cohort Studies; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010809:Physical Fitness; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein
keywords: C-reactive protein; Lung neoplasms; Men; Physical fitness