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  • 1
    Keywords: CANCER ; BLOOD ; Germany ; THERAPY ; RISK ; RISKS ; PROTEIN ; colon ; CYCLE ; ASSOCIATION ; hormone ; HEALTH ; resistance ; AGE ; WOMEN ; MEN ; OBESITY ; smoking ; COLORECTAL-CANCER ; cancer risk ; COLON-CANCER ; cholesterol ; C-REACTIVE PROTEIN ; body mass index ; nutrition ; education ; NESTED CASE-CONTROL ; CROHNS-DISEASE ; inflammation ; insulin ; SERUM ; case-control study ; REGRESSION ; ASSOCIATIONS ; colon cancer ; METAANALYSIS ; PHASE ; INSULIN-RESISTANCE ; metabolic syndrome ; REPLACEMENT THERAPY ; prospective ; CANCER-RISK ; colorectal neoplasms ; C-PEPTIDE ; REPLACEMENT ; WAIST CIRCUMFERENCE ; INFLAMMATORY MARKERS ; nested case-control study ; BODY-MASS ; COLLECTION ; HORMONE-THERAPY ; Abdominal ; Hyperinsulinism ; journals ; nested case control study ; hyperglycemia ; hyperlipidemias
    Abstract: The authors investigated associations between serum C-reactive protein (CRP) concentrations and colon and rectal cancer risk in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (1992-2003) among 1,096 incident cases and 1,096 controls selected using risk-set sampling and matched on study center, age, sex, time of blood collection, fasting status, menopausal status, menstrual cycle phase, and hormone replacement therapy. In conditional logistic regression with adjustment for education, smoking, nutritional factors, body mass index, and waist circumference, CRP showed a significant nonlinear association with colon cancer risk but not rectal cancer risk. Multivariable-adjusted relative risks for CRP concentrations of 〉= 3.0 mg/L versus 〈 1.0 mg/L were 1.36 (95% confidence interval (CI): 1.00, 1.85; P-trend = 0.01) for colon cancer and 1.02 (95% CI: 0.67, 1.57; P-trend = 0.65) for rectal cancer. Colon cancer risk was significantly increased in men (relative risk = 1.74, 95% CI: 1.11, 2.73; P-trend = 0.01) but not in women (relative risk = 1.06, 95% CI: 0.67, 1.68; P-trend = 0.13). Additional adjustment for C-peptide, glycated hemoglobin, and high density lipoprotein cholesterol did not attenuate these results. These data provide evidence that elevated CRP concentrations are related to a higher risk of colon cancer but not rectal cancer, predominantly among men and independently of obesity, insulin resistance, and dyslipidemia
    Type of Publication: Journal article published
    PubMed ID: 20634278
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  • 2
    Keywords: SURVIVAL ; colon ; HEALTH ; WOMEN ; colorectal cancer ; REGION ; UNITED-STATES ; nutrition ; INEQUALITIES ; rectum ; SOCIOECONOMIC-STATUS ; DEPRIVATION ; Educational level ; Tumor Location
    Abstract: Existing evidence is inconclusive on whether socioeconomic status (SES) and educational inequalities influence colorectal cancer (CRC) risk, and whether low or high SES/educational level is associated with developing CRC. The aim of our study was to investigate the relationship between educational level and CRC. We studied data from 400,510 participants in the EPIC (European Prospective Investigation into Cancer and Nutrition) study, of whom 2,447 developed CRC (colon: 1,551, rectum: 896, mean follow-up 8.3 years). Cox proportional hazard regression analysis stratified by age, gender and center, and adjusted for potential confounders were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). Relative indices of inequality (RII) for education were estimated using Cox regression models. We conducted separate analyses for tumor location, gender and geographical region. Compared with participants with college/university education, participants with vocational secondary education or less had a nonsignificantly lower risk of developing CRC. When further stratified for tumor location, adjusted risk estimates for the proximal colon were statistically significant for primary education or less (HR 0.73, 95% CI 0.57-0.94) and for vocational secondary education (HR 0.76, 95% CI 0.58-0.98). The inverse association between low education and CRC risk was particularly found in women and Southern Europe. These associations were statistically significant for CRC, for colon cancer and for proximal colon cancer. In conclusion, CRC risk, especially in the proximal colon, is lower in subjects with a lower educational level compared to those with a higher educational level. This association is most pronounced in women and Southern Europe
    Type of Publication: Journal article published
    PubMed ID: 21412763
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