C-reactive protein; a potential marker of second cancer and cardiovascular disease in testicular cancer survivors?

IntroductionC-reactive protein (CRP) is a marker of cardiovascular disease (CVD). There is conflicting evidence regarding CRP as a marker of future cancer. We studied whether CRP predicts CVD and consecutive cancer in testicular cancer survivors (TCSs).Patients and methodsDuring 1998–2001, 586 TCSs with a high sensitivity CRP ⩽10 mg/L were identified median 11 (4–21) years after treatment (FU-1). A second follow-up survey (FU-2) was conducted median 8 (6–9) years after FU-1. At FU-2 we obtained information about post-FU-1 CVD (cardiovascular death, nonfatal myocardial infarction, stroke, revascularisation or heart failure). Information about post-FU-1 non-germ cell cancer and cardiovascular death in all patients were retrieved from the Cancer Registry of Norway.ResultsAfter FU-1 31 (5.3%) of 586 patients developed non-germ cell cancer (excluding localised prostate cancer), while 28 (4.9%) developed CVD. Cox regression analyses showed that patients with CRP ⩾1.5 mg/L had 2.21 (95% CI 1.04–4.70) times higher risk of developing non-germ cell cancer and 2.79 (95% CI 1.22–6.34) times higher risk for CVD compared to patients with CRP <1.5 mg/L at FU-1.ConclusionIn long-term TCSs, CRP may serve as a potential marker of cardiovascular events and a second cancer.