Interleukin-6 and risk of colorectal cancer: results from the CLUE II cohort and a meta-analysis of prospective studies

Artemisia Kakourou, Charalampia Koutsioumpa, David S. Lopez, Judith Hoffman-Bolton, Gary Bradwin, Nader Rifai, Kathy J. Helzlsouer, Elizabeth A. Platz, Konstantinos K. Tsilidis

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


Purpose: The association between prediagnostic interleukin-6 (IL-6) concentrations and risk of colorectal cancer was evaluated in a nested case–control study and a meta-analysis of prospective studies. Methods: Colorectal cancer cases (n = 173) and matched controls (n = 345) were identified between 1989 and 2000 among participants in the CLUE II cohort of Washington Country, Maryland. Matched odds ratios and the corresponding 95 % confidence intervals (CIs) were estimated using conditional logistic regression models. Results: Participants in the highest third of plasma IL-6 concentration had a 2.48 times higher risk of colon cancer compared to participants in the bottom third (95 % CI 1.26–4.87; p-trend 0.02) after multivariate adjustment. This association did not differ according to the stage of disease, age, sex, or other potential modifying variables and remained statistically significant after adjustment for C-reactive protein concentrations. No statistically significant association was observed for rectal cancer risk. The meta-analysis of six prospective studies yielded an increased but borderline statistically significant risk of colon cancer per 1 U increase in naturally logarithm-transformed IL-6 (summary RR 1.22; 95 % CI 1.00–1.49; I2 46 %). An inverse association was noted for rectal cancer (RR 0.69; 95 % CI 0.54–0.88; I2 0 %), but there was evidence for small-study effects (p 0.02). Conclusion: Our findings provide support for a modest positive association between IL-6 concentrations and colon cancer risk. More work is needed to determine whether IL-6 is a valid marker of colorectal inflammation and whether such inflammation contributes to colon and rectal cancer risk.

Original languageEnglish (US)
Pages (from-to)1449-1460
Number of pages12
JournalCancer Causes and Control
Issue number10
StatePublished - Oct 14 2015
Externally publishedYes


  • Cohort study
  • Colorectal cancer
  • Inflammation
  • Meta-analysis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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