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A predictive role of C-reactive protein in colorectal cancer risk: an updated meta-analysis from 780,985 participants and 11,289 cancer cases

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Abstract

Purpose

This meta-analysis is aimed at understanding the potential role of circulating C-reactive protein (CRP) in the prediction of colorectal cancer (CRC) risk and the potential effect of relevant variables, with specific concern to determine the incorporation of CRP into a CRC risk prediction model.

Methods

Relevant articles on the association between circulating CRP and CRC risk were searched from PubMed, Embase, Web of Science, and Cochrane Database of Systematic Reviews through August 2022. Random-effects models were used to estimate the pooled relative risk (RR) for the highest versus lowest CRP categories. Linear and non-linear trend analyses were conducted to explore the dose–response associations between CRP and CRC risk.

Results

Twenty-three articles including 780,985 participants and 11,289 cancer cases met the selection criteria. The overall result demonstrated a remarkable association between elevated CRP levels and CRC risk (RR, 1.259; 95% CI, 1.060–1.457), but not in dose–response analysis (RR, 1.002 (95% CI, 0.964–1.041) per natural log unit change in CRP). Subgroup analyses indicated a significant difference when grouped by study location, the length of follow-up, and gender composition. No evidence of publication bias was observed.

Conclusion

The predictive role of CRP in CRC incidence is limited to colon cancer and a period of 10 years after the initial discovery of CRP elevation. The result did not support the etiological role of CRP in CRC and the inclusion of CRP into the CRC risk prediction model.

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Data Availability

All data supporting the findings of this study are available in this published article and its supplementary information.

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  1. Liang Han, Yongzhong Guo, and Dunqiang Ren contributed equally to this study.

Authors and Affiliations

  1. Department of Oncology, Xuzhou Central Hospital , The Xuzhou School of Clinical Medicine of Nanjing Medical University, Clinical School of Xuzhou Medical University, Xuzhou, China

    Liang Han

  2. Department of Respiratory and Critical Care Medicine, Xuzhou Central Hospital, The Xuzhou School of Clinical Medicine of Nanjing Medical University, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China

    Yongzhong Guo

  3. Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China

    Dunqiang Ren

  4. Department of Radiotherapy, Xuzhou Central Hospital, The Xuzhou School of Clinical Medicine of Nanjing Medical University, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China

    Hui Hui, Na Li & Xiaoxuan Xie

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Contributions

Liang Han and Xiaoxuan Xie conceived and designed the study; Yongzhong Guo, Xiaoxuan Xie and Dunqiang Ren selected the studies; Hui Hui, Xiaoxuan Xie, and Na Li extracted the data; Yongzhong Guo and Xiaoxuan Xie performed the statistical analyses; Liang Han, Xiaoxuan Xie, Dunqiang Ren, and Yongzhong Guo wrote the manuscript; Liang Han, Xiaoxuan Xie, Yongzhong Guo, and Dunqiang Ren prepared Tables 1 and 2 and Figs. 1, 2, 3, and 4; all authors prepared the supplementary material. All authors reviewed the manuscript.

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Han, L., Guo, Y., Ren, D. et al. A predictive role of C-reactive protein in colorectal cancer risk: an updated meta-analysis from 780,985 participants and 11,289 cancer cases. Int J Colorectal Dis 38, 121 (2023). https://doi.org/10.1007/s00384-023-04419-4

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