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Chronic inflammation and risk of lung cancer in older adults in the health,aging and body composition cohort study
Authors:Joshua Demb  Esther K Wei  Monika Izano  Stephen Kritchevsky  Helen Swede  Anne B Newman  Michael Shlipak  Tomi Akinyemiju  Steven Gregorich  Dejana Braithwaite
Institution:1. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States;2. California Pacific Medical Center Research Institute, San Francisco, CA, United States;3. Department of Epidemiology, University of California, Berkeley, CA, United States;4. Wake Forest School of Medicine, Winston-Salem, NC, United States;5. Department of Community Medicine and Healthcare, University of Connecticut School of Medicine, Farmington, CT, United States;6. School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States;7. Department of Epidemiology, University of Kentucky, Lexington, KY, United States;8. Department of Medicine, University of California, San Francisco, CA, United States;9. Department of Oncology, Georgetown University, Washington, DC, United States
Abstract:

Objectives

We examined the association between three inflammatory markers (Interleukin (IL)-6, C-reactive protein (CRP), tumor necrosis factor (TNF)-α) and incident lung cancer using baseline, updated, and averaged inflammatory measures in older adults.

Methods

We fitted multivariable Cox models to assess whether circulating levels of inflammation markers were associated with incident lung cancers in the Health Aging, Body and Composition (HealthABC) prospective cohort of 3075 older adults aged 70–79?years at baseline. IL-6 and CRP were measured biennially, whereas TNF-α was measured at baseline.

Results

Baseline levels of IL-6 were significantly associated with incident lung cancer risk in a model that adjusted for age, gender, race, and site (Model 1) (Hazard RatioT3 vs. T1: 3.34, 95% Confidence Interval: 1.91, 5.85) and in a model adjusted for health factors linked to chronic inflammation (Model 2) (HR T3 vs. T1: 2.57, 95% CI: 1.41, 4.65). The associations observed in time-updated IL-6 (HR T3 vs. T1: 2.47, 95% CI: 1.43, 4.28), cumulatively averaged IL-6 (HR T3 vs. T1: 2.47, 95% CI: 1.43, 4.35), and baseline CRP levels (HR T3 vs. T1: 1.85, 95% CI: 1.11, 3.08) with incident lung cancer in Model 1 were not statistically significant in Model 2.

Conclusions

Baseline CRP and IL-6 levels were associated with increased risk of lung cancer in Model 1 and both models, respectively. Chronic IL-6 inflammation, as quantified by repeated measures was associated with incident lung cancer in Model 1, but not Model 2. Further research is needed to understand the role of CRP and IL-6 in lung carcinogenesis.
Keywords:Health ABC Study  Health  Aging  and Body Composition Study  Vs  versus  C-reactive protein  CRP  Interleukin-6  IL-6  Tumor necrosis factor-α  TNF-α  BMI  body mass index  HR  hazard ratio  SHR  subdistribution hazard ratio  95% CI  95% confidence interval  kg  kilograms  L  liters  mg  milligrams  mL  milliliters  μg  micrograms  pg  picograms  cm  centimeters  ICD  International Classification of Diseases  IQ  interquartile range  Lung cancer  Inflammatory markers  Incidence  Pulmonary
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