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  • Among those born in Mexico median levels of CRP were

    2019-08-11

    Among those born in Mexico, median levels of CRP were gradually increased with years of living in U.S, particularly among men. Such association was further confirmed in the multivariable analysis. Coupled with the observation that median CRP levels were higher among those born in U.S. than their counterpart in both men (P = 0.029) and women (P = 0.076), we can assume that the adoption of American culture and behaviors, such as being overweight or obese, leading a sedentary lifestyle, being lack of sleep, and eating fast or processed foods, during the immigration and acculturation may influence CRP levels. With more accustomed to American lifestyle, the prevalence of such unhealthy behaviors is likely to increase. As shown in this study, both being over-weight or obese and physically inactive are correlated with increased CRP levels. Although we already included BMI, physical activity, cigarette smoking, and alcohol drinking in the analysis, there are still a few potential confounding factors left out, such as sleep and diet. The impact of sleep loss on CRP levels has been reported previously [37]. And dietary fatty SPDP intake has been shown to affect serum CRP levels [38]. In addition, this study examined the relationship between elevated CRP and incidents of cancer among Mexican Americans who experienced cancer at follow-up. We found a significant dose-response trend between increased CRP levels and increased risk of all cancer. Our results are consistent with literature reports from several prospective cohort studies that have shown that elevated serum CRP levels are associated with increased risk of cancer [[9], [10], [11], [12], [13], [14]]. Since our study is a prospective cohort study, we have the ability to determine temporal exposure in relation to disease and evaluate the possibility of reverse causation. As the associations we observe are only evident among cases occurring more than 5 years of follow-up, our results suggest increased levels of serum CRP may be a cancer risk factor, not a biomarker of subclinical cancer in Mexican Americans. Our observations are also consistent with the notion that CRP is a marker for systemic inflammation.
    Authorship contribution
    Funding sources The Mexican American Cohort receives funds collected pursuant to the Comprehensive Tobacco Settlement of 1998 and appropriated by the 76th legislature to The University of Texas MD Anderson Cancer Center and from the Caroline W. Law Fund for Cancer Prevention and the Duncan Family Institute for Risk Assessment and Cancer Prevention.
    Declaration of interest
    Acknowledgements
    Introduction Esophageal cancer is the eighth most common malignancy and the sixth most common cause of cancer death worldwide [1]. Esophageal squamous cell carcinoma (ESCC), the most common histologic type of esophageal cancer, has a very unusual geographic distribution, with distinct areas of high risk across central Asia and from eastern to southern Africa [2]. Western Kenya and the Eastern Cape Province of South Africa have long been reported as endemic areas of ESCC [[3], [4], [5]], but a larger corridor, from Ethiopia to South Africa, has recently been recognized as having a similar high risk [[6], [7], [8]]. Esophageal cancer often presents late and carries a poor prognosis, but microgametophyte is particularly true in low-resource settings, where 5-year survival is often <5% [9], and palliation is too often the only option [10]. Environmental causes of esophageal cancer are numerous, complex, and not fully understood [11]. Research on the etiology and modifiable risk factors of ESCC in Africa is limited [7]. ESCC is the most commonly diagnosed cancer at Tenwek Hospital, a 300-bed mission hospital in Bomet, western Kenya. In 2016, over 400 ESCC patients were diagnosed. A striking characteristic of Bomet, even among other endemic areas, is the high proportion of cases diagnosed at a young age. This finding is particularly striking in the majority Kalenjin population, where 9% of all cases are <30 years old and 20% are <40 years old [4].