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Lung Cancer |

Elevated C-Reactive Protein Is Associated With Increased Risk of Mortality From Lung Cancer in the United States

Bethany Doran, MPH; Sripal Bangalore, MHA
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NYUMC, New York, NY


Chest. 2014;146(4_MeetingAbstracts):592A. doi:10.1378/chest.1983183
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Abstract

SESSION TITLE: Lung Cancer Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Inflammation is thought to play a key role in the development and progression of lung cancer through repeated exposure to toxic substances causing irritation to the lung parenchyma resulting in inflammatory responses that promote tumor growth and progression. No prior studies have had sufficient sample sizes or used a representative cohort to examine whether higher baseline inflammatory markers are associated with increased risk of mortality from lung cancer.

METHODS: Using the National Health and Nutrition Database III linked to the National Death Index with follow up through 2006, we examined the relationship between elevated levels of CRP (defined as those with levels in the top quartile or >4.4 mg/dL) to overall cancer mortality and lung cancer mortality using Cox-proportional hazards modeling. We also performed a dose-response analysis of cancer mortality risk by CRP level.

RESULTS: Our sample included 15,863 US adults, with 662 deaths from any cancer and 232 lung cancer deaths. After adjustment for potential cofounders including smoking history, age, race, gender, prior history of cancer, enlarged waist circumference, and socioeconomic status, individuals with an elevated CRP had a 41% increased risk of death from any cancer (HR =1.41, 95% CI 1.20-1.67; P <0.001), driven by a 95% increased risk of death from lung cancer (HR=1.95, 95% CI 1.47-2.59, P <0.001) compared to those without an elevated CRP. Evaluation of dose response curves for overall cancers showed increasing association of CRP level with mortality from all cancers from levels of 3 mg/dL until approximately 5 mg/dL.

CONCLUSIONS: In a representative US cohort including men and women, elevated CRP levels are associated with a significant increase in the risk of death from any cancer, driven by a significant increase in the risk of death from lung cancer in individuals, even after controlling for smoking and prior history of cancer.

CLINICAL IMPLICATIONS: This study suggests that CRP may have useful prognostic value to assess patients at increased risk of malignancy from lung cancer. More research is needed to determine whether decreasing the inflammatory state in individuals may decrease risk of mortality from cancer.

DISCLOSURE: The following authors have nothing to disclose: Bethany Doran, Sripal Bangalore

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