title: The Association of the C-Reactive Protein Inflammatory Biomarker with Breast Cancer Incidence and Mortality in the Women's Health Initiative.
abstract: Purpose:To examine associations of prediagnosis high-sensitivity C-reactive protein (hsCRP) with breast cancer incidence and postdiagnosis survival and to assess whether associations are modified by body mass index (BMI).Methods:A prospective analysis of the Women's Health Initiative was conducted among 17,841 cancer-free postmenopausal women with baseline hsCRP measurements. Cox proportional hazards models were used to examine associations between hsCRP concentrations and (i) breast cancer risk (ncases = 1,114) and (ii) all-cause mortality after breast cancer diagnosis. HRs are per 1 SD in log hsCRP.Results:hsCRP was not associated with breast cancer risk overall [HR = 1.05; 95% confidence interval (CI), 0.98-1.12]; however, an interaction between BMI and hsCRP was observed (Pinteraction= 0.02). A 1 SD increase in log hsCRP was associated with 17% increased breast cancer risk (HR = 1.17; 95% CI, 1.03-1.33) among lean women (BMI < 25), whereas no association was observed among overweight/obese (BMI ≥ 25) women. Prediagnosis hsCRP was not associated with overall mortality (HR, 1.04; 95% CI, 0.88-1.21) after breast cancer diagnosis; however, an increased mortality risk was apparent among leaner women with higher hsCRP levels (HR, 1.39, 95% CI, 1.03-1.88).Conclusions:Prediagnosis hsCRP levels are not associated with postmenopausal breast cancer incidence or survival overall; however, increased risks are suggested among leaner women. The observed effect modification is in the opposite direction of a previous case-control study finding and warrants further investigation.Impact:Associations of higher CRP levels with incident breast cancer and survival after breast cancer may depend on BMI.Cancer Epidemiol Biomarkers Prev; 26(7); 1100-6. ©2017 AACR.
authors.affiliation: Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California. s8nelson@ucsd.edu.
authors.forename: Sandahl H
authors.initials: SH
authors.lastname: Nelson
authors.affiliation: Division of Cancer Prevention and Control, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Theodore M
authors.initials: TM
authors.lastname: Brasky
authors.affiliation: Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Patterson
authors.affiliation: Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California.
authors.forename: Gail A
authors.initials: GA
authors.lastname: Laughlin
authors.affiliation: Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California.
authors.forename: Donna
authors.initials: D
authors.lastname: Kritz-Silverstein
authors.affiliation: Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Beatrice J
authors.initials: BJ
authors.lastname: Edwards
authors.affiliation: Department of Family, Population & Preventive Medicine, Stony Brook School of Medicine, Stony Brook, New York.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Lane
authors.affiliation: Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Rohan
authors.affiliation: Department of Occupational Medicine, Epidemiology and Prevention, Feinstein Institute for Medical Research, Hofstra Northwell School of Medicine, Great Neck, New York.
authors.forename: Gloria Y F
authors.initials: GYF
authors.lastname: Ho
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.affiliation: Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California.
authors.forename: Andrea Z
authors.initials: AZ
authors.lastname: LaCroix
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000097:blood* / Q000453:epidemiology*; D002097:C-Reactive Protein / Q000032:analysis*; D000073116:Cancer Survivors / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D050177:Overweight / Q000097:blood / Q000401:mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D016387:Women's Health
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein