C-reactive protein and the risk of cancer: a mendelian randomization study

J Natl Cancer Inst. 2010 Feb 3;102(3):202-6. doi: 10.1093/jnci/djp459. Epub 2010 Jan 7.

Abstract

Elevated plasma levels of C-reactive protein (CRP), a marker of inflammation, are associated with an increased risk of cancer, but it is unclear whether this association is causal. We examined whether four common single-nucleotide polymorphisms (SNPs) in the CRP gene that are associated with altered plasma CRP levels are causally associated with an increased risk of cancer. The study population included participants in a prospective study (n = 10 215) and a cross-sectional study (n = 36 403) of the adult general population in Denmark, all of whom were genotyped for the CRP SNPs. The association between plasma CRP levels measured by a high-sensitivity turbidimetry assay and the risk of cancer was examined for 8224 participants in the prospective study. The hazard ratio of cancer for a doubling of the plasma CRP level was 1.09 (95% confidence interval [CI] = 1.03 to 1.14). The nine most common genotype combinations of the four CRP SNPs were associated with up to a 72% increase (95% CI = 58% to 87%) in CRP levels but not with an increased risk of cancer. The estimated causal odds ratio for cancer associated with a genetically induced doubling in CRP level was 0.94 (95% CI = 0.81 to 1.08). This finding suggests that elevated CRP levels do not cause cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / blood
  • Biomarkers, Tumor / genetics*
  • C-Reactive Protein / genetics*
  • C-Reactive Protein / metabolism
  • Cross-Sectional Studies
  • Denmark / epidemiology
  • Female
  • Genotype
  • Humans
  • Inflammation / metabolism
  • Male
  • Mendelian Randomization Analysis*
  • Middle Aged
  • Neoplasms / blood*
  • Neoplasms / epidemiology*
  • Odds Ratio
  • Polymorphism, Single Nucleotide*
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Assessment
  • Risk Factors

Substances

  • Biomarkers, Tumor
  • C-Reactive Protein