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June 16, 2004

C-Reactive Protein and Risk of Colon Cancer

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(23):2818-2819. doi:10.1001/jama.291.23.2818-b

To the Editor: Dr Erlinger and colleagues1 reported that C-reactive protein (CRP) levels were associated with risk of colon cancer. We have suggested that CRP is not merely a nonspecific marker of inflammation but has several important proinflammatory effects.2,3 In particular, CRP may activate endothelial cells, monocytes and smooth muscle cells, induce expression of adhesion molecules,2 chemoactractants,3 tissue factor, and activate the NF-κB pathway.4 Although we are not aware of any studies on the effect of CRP on cancer cells or on epithelial cells of the gastrointestinal tract, expression of adhesion molecules is important for cancer invasion and activation of the NF-κB pathway may have important oncogenic effects.5

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