Pre-diagnostic C-reactive protein concentrations, CRP genetic variation and mortality among individuals with colorectal cancer in Western European populations


  • K. Nimptsch
  • K. Aleksandrova
  • V. Fedirko
  • M. Jenab
  • M.J. Gunter
  • P.D. Siersema
  • K. Wu
  • V. Katzke
  • R. Kaaks
  • S. Panico
  • D. Palli
  • A.M. May
  • S. Sieri
  • B. Bueno-de-Mesquita
  • K. Standahl
  • M.J. Sánchez
  • A. Perez-Cornago
  • A. Olsen
  • A. Tjønneland
  • C.B. Bonet
  • C.C. Dahm
  • M.D. Chirlaque
  • V. Fiano
  • R. Tumino
  • A. Barricarte Gurrea
  • M.C. Boutron-Ruault
  • F. Menegaux
  • G. Severi
  • B. van Guelpen
  • Y.A. Lee
  • T. Pischon


  • BMC Cancer


  • BMC Cancer 22 (1): 695


  • BACKGROUND: The role of elevated pre-diagnostic C-reactive protein (CRP) concentrations on mortality in individuals with colorectal cancer (CRC) remains unclear. METHODS: We investigated the association between pre-diagnostic high-sensitivity CRP concentrations and CRP genetic variation associated with circulating CRP and CRC-specific and all-cause mortality based on data from 1,235 individuals with CRC within the European Prospective Investigation into Cancer and Nutrition cohort using multivariable-adjusted Cox proportional hazards regression. RESULTS: During a median follow-up of 9.3 years, 455 CRC-specific deaths were recorded, out of 590 deaths from all causes. Pre-diagnostic CRP concentrations were not associated with CRC-specific (hazard ratio, HR highest versus lowest quintile 0.92, 95% confidence interval, CI 0.66, 1.28) or all-cause mortality (HR 0.91, 95% CI 0.68, 1.21). Genetic predisposition to higher CRP (weighted score based on alleles of four CRP SNPs associated with higher circulating CRP) was not significantly associated with CRC-specific mortality (HR per CRP-score unit 0.95, 95% CI 0.86, 1.05) or all-cause mortality (HR 0.98, 95% CI 0.90, 1.07). Among four investigated CRP genetic variants, only SNP rs1205 was significantly associated with CRC-specific (comparing the CT and CC genotypes with TT genotype, HR 0.54, 95% CI 0.35, 0.83 and HR 0.58, 95% CI 0.38, 0.88, respectively) and all-cause mortality (HR 0.58, 95% CI 0.40, 0.85 and 0.64, 95% CI 0.44, 0.92, respectively). CONCLUSIONS: The results of this prospective cohort study do not support a role of pre-diagnostic CRP concentrations on mortality in individuals with CRC. The observed associations with rs1205 deserve further scientific attention.