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1 Wake Forest University School of Medicine, Winston-Salem, North Carolina; 2 University of Wisconsin, Madison, Wisconsin; 3 Laboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; 4 University of Pittsburgh, Pittsburgh, Pennsylvania; 5 University of California-San Francisco, San Francisco, California; and 6 University of Tennessee, Memphis, Tennessee
Requests for reprints: Dora Il'yasova, PhD, Cancer Prevention, Detection and Control Research Program, Box 2949, Duke University Medical Center, Durham, NC 27710. Phone: 919-668-6531; Fax: 919-681-4785. E-mail: dora.ilyasova{at}duke.edu
Background: Chronic inflammation is associated with processes that contribute to the onset or progression of cancer. This study examined the relationships between circulating levels of the inflammatory markers interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-
(TNF-) and total as well as site-specific cancer incidence.
Methods: Study subjects (n = 2,438) were older adults (ages 70-79 years) participating in the Health Aging and Body Composition study, who did not report a previous cancer diagnosis (except for nonmelanoma skin cancer) at baseline. Incident cancer events (n = 296) were ascertained during an average follow-up of 5.5 years. Inflammatory markers were measured in stored baseline fasting blood samples.
Results: The adjusted hazard ratios (95% confidence intervals) for incident cancer associated with a 1-unit increase on the natural log-scale were 1.13 (0.94-1.37), 1.25 (1.09-1.43), and 1.28 (0.96-1.70) for IL-6, CRP, and TNF-, respectively. Markers were more strongly associated with cancer death: hazard ratios were 1.63 (1.19-2.23) for IL-6, 1.64 (1.20-2.24) for CRP, and 1.82 (1.14-2.92) for TNF-. Although precision was low for site-specific analyses, our results suggest that all three markers were associated with lung cancer, that IL-6 and CRP were associated with colorectal cancer, and that CRP was associated with breast cancer. Prostate cancer was not associated with any of these markers.
Conclusions: These findings suggest that (a) the associations between IL-6, CRP, and TNF- and the risk of cancer may be site specific and (b) increased levels of inflammatory markers are more strongly associated with the risk of cancer death than cancer incidence.
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