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June 16, 2004

C-Reactive Protein and Risk of Colon Cancer—Reply

Author Affiliations

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

JAMA. 2004;291(23):2818-2819. doi:10.1001/jama.291.23.2819-b

In Reply: Drs Pasceri and Cammarota raise the possibility that CRP may have a direct role in the pathogenesis of colon cancer due to its direct proinflammatory effects. We agree that CRP appears to have direct proinflammatory effects and could be more than a marker of inflammation. However, as they point out, data are sparse in relation to direct effects of CRP on cancer cells, in contrast to a growing literature suggesting direct effects of IL-6 on cancer cells. Further studies are needed to clarify this issue. We also agree that studies of anti-inflammatory agents should be examined for effect modification in relation to any associations with CRP and cancer outcomes. For cardiovascular disease, use of aspirin appears to strongly modify the associations between CRP and cardiovascular outcomes.1 Similar analyses with cancer would be of great interest, as would analyses of potential effect modification by use of female hormones.

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