{
  "abstract": "Background/Objectives: Prospective studies have reported associations between systemic inflammatory biomarkers and colorectal cancer (CRC) risk, but whether these reflect a causal role of inflammation or responses to preclinical disease remains uncertain. Methods: Using data from 383,850 UK Biobank participants (aged 40-69 years; recruited 2006-2010), we investigated potential reverse causality by assessing these associations according to time since biomarker assessment. Baseline systemic inflammatory markers, including C-reactive protein (CRP), albumin, and blood cell-derived ratios, were assessed. Multivariable Cox models estimated associations with CRC risk across predefined follow-up intervals. Results: Over a median follow-up of 11.8 years, 4996 participants developed CRC. Inflammatory biomarkers were associated with increased CRC risk, particularly during the early follow-up. Associations weakened substantially or disappeared when early follow-up was excluded. For example, CRP was associated with a 3.03-fold higher CRC risk (highest vs. lowest quartile; 95% CI: 2.06-4.45) within the 0-1-year interval, while no association was observed during the 3-5, 6-8, or >8-year intervals. Across complete follow-up, the association remained statistically significant but much weaker (HR: 1.17; 95% CI: 1.07-1.28). Similar patterns were observed for most other biomarkers, except the platelet-to-neutrophil ratio. Conclusions: Our results suggest that the associations between inflammatory biomarkers and CRC risk may partly reflect reverse causality arising from preclinical disease.",
  "abstract_shown": true,
  "affiliations": [
    "Cancer Prevention Graduate School, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.",
    "Division of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Fatemeh Safizadeh",
      "orcid": "0000-0002-3293-9499"
    },
    {
      "affs": [
        1
      ],
      "name": "Tafirenyika Gwenzi",
      "orcid": "0000-0001-5683-6315"
    },
    {
      "affs": [
        0
      ],
      "name": "Marko Mandic",
      "orcid": "0000-0002-7372-8284"
    },
    {
      "affs": [
        1
      ],
      "name": "Michael Hoffmeister"
    },
    {
      "affs": [
        0
      ],
      "name": "Hermann Brenner",
      "orcid": "0000-0002-6129-1572"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ag3bynsnvzn3s.bib",
  "cited_by": 0,
  "doi": "10.3390/cancers18193190",
  "fulltext_url": "https://europepmc.org/articles/PMC13663995",
  "id": "ag3bynsnvzn3s",
  "issns": [
    "2072-6694"
  ],
  "landing_url": "https://europepmc.org/article/MED/42882884",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2730|Inflammatory Biomarkers in Disease Prognosis"
    ]
  ],
  "openalex": "W7215690423",
  "pdf_url": "https://europepmc.org/articles/PMC13663995?pdf=render",
  "pmcid": "PMC13663995",
  "pmid": "42882884",
  "published": "2026-10-02",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/ag3bynsnvzn3s.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:00Z",
      "native_id": "MED:42882884",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42882884"
    },
    {
      "first_seen": "2026-10-30T12:19:58Z",
      "native_id": "10.3390/cancers18193190",
      "source": "crossref",
      "url": "https://www.mdpi.com/2072-6694/18/19/3190"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Inflammatory Biomarkers in Disease Prognosis",
      "subfield": "oncology"
    }
  ],
  "title": "Systemic Inflammation and Colorectal Cancer: Assessing the Role of Reverse Causality.",
  "title_text": "Systemic Inflammation and Colorectal Cancer: Assessing the Role of Reverse Causality.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:58Z",
  "url": "https://research.draconitic.com/paper/ag3bynsnvzn3s",
  "venue": "Cancers",
  "versions": []
}