Abstract 1079: Markers of inflammation and risk of prostate cancer: Results from a 20-year follow-up study.
Authors: Toriola Adetunji T. , Laukkanen Jari , Kurl Sudhir , Ronkainen Kimmo , Nyyssönen Kristiina , Kauhanen Jussi 
Published: August 2014

Introduction: Evidence from clinical, histopathological and epidemiological studies suggest that inflammation plays a role in prostate carcinogenesis. However, studies investigating these associations using biomarkers of inflammation such as C-reactive protein (CRP) and interleukin-6 (IL-6) have reported conflicting results. A meta-analysis of six studies reported no associations between CRP and risk of prostate cancer while an inverse association was reported for IL-6, although the analysis was limited to only three studies. Because of the conflicting findings from previous studies, we investigated the associations of four markers of inflammation (CRP, fibrinogen albumin and leucocyte) and risk of prostate cancer.

Methods: We investigated these associations in a prospective cohort study involving 2,627 middle-aged men from Eastern Finland who had baseline examination and blood draw between March 1984 and December 1989. During a follow-up period lasting twenty years, with virtually no losses to follow-up, 203 men developed prostate cancer. They were identified through linkage with the nationwide, population-based Finnish Cancer Registry, using the unique personal identification number available to all residents of Finland. Associations between the markers and risk of prostate cancer were examined using Cox proportional hazards model, adjusting for known and potential confounders (age, examination year, socioeconomic status, alcohol consumption, energy intake, cardiorespiratory fitness, body mass index and pack-years of smoking).

Results: Elevated pre-diagnostic serum albumin and leucocyte count, but not serum CRP and fibrinogen concentrations were associated with statistically significantly increased risk of prostate cancer. In multivariate adjusted analyses, the relative risks (RRs, 95%CI) of prostate cancer among men in the highest quartiles of albumin and leucocyte concentrations compared to men in the lowest quartiles were 1.39 (95%CI 1.10-1.91, p-trend=0.04) and 1.60 (95%CI 1.10-2.29, p-trend=0.01), respectively. The relative risks of prostate cancer among men in the highest quartiles of CRP and fibrinogen concentrations compared to those in the lowest quartiles were 1.08 (95%CI 0.74-1.60, p-trend=0.56) and 1.25 (95%CI 0.87-1.81, p-trend=0.14), respectively.

Conclusions: To the best of our knowledge, this is the first prospective study to observe positive associations between pre-diagnostic serum albumin concentrations, leucocyte count and the risk of prostate cancer. Similar to previous epidemiological studies, we observed no significant positive associations between CRP concentrations and the risk of prostate cancer. The results from our study suggest that markers of inflammation may have differential associations with prostate cancer risk.

Citation Format: Adetunji T. Toriola, Jari Laukkanen, Sudhir Kurl, Kimmo Ronkainen, Kristiina Nyyssönen, Jussi Kauhanen. Markers of inflammation and risk of prostate cancer: Results from a 20-year follow-up study. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1079. doi:10.1158/1538-7445.AM2013-1079