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No association between genetically predicted C-reactive protein levels and colorectal cancer survival in Korean: two-sample Mendelian randomization analysis
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Chang Kyun Choi
 , Jung-Ho Yang, Min-Ho Shin, Sang-Hee Cho, Sun-Seog Kweon
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Epidemiol Health. 2023;45:e2023039. Published online March 22, 2023
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DOI: https://doi.org/10.4178/epih.e2023039
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 Abstract
Summary
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Abstract
OBJECTIVES
Elevated C-reactive protein (CRP) levels are associated with an increased risk for colorectal cancer (CRC), as well as a poor prognosis, but it remains unclear whether these associations are causal. This study examined the potential causality between CRP levels and CRC survival using 2-sample Mendelian randomization (MR).
METHODS From the Korean Genome and Epidemiology Study, a genome-wide association study (n=59,605), 7 single-nucleotide polymorphisms (SNPs) related to log2-transformed CRP levels were extracted as instrumental variables for CRP levels. The associations between the genetically predicted CRP and CRC-specific and overall mortality among CRC patients (n=6,460) were evaluated by Aalen’s additive hazard model. The sensitivity analysis excluded a SNP related to the blood lipid profile.
RESULTS During a median of 8.5 years of follow-up, among 6,460 CRC patients, 2,676 (41.4%) CRC patients died from all causes and 1,622 (25.1%) died from CRC. Genetically predicted CRP levels were not significantly associated with overall or CRC-specific mortality in CRC patients. The hazard difference per 1,000 person-years for overall and CRC-specific mortality per 2-fold increase in CRP levels was -2.92 (95% confidence interval [CI], -14.05 to 8.21) and -0.76 (95% CI, -9.61 to 8.08), respectively. These associations were consistent in a subgroup analysis according to metastasis and a sensitivity analysis excluding possible pleiotropic SNPs.
CONCLUSIONS Our findings do not support a causal role for genetically predisposed CRP levels in CRC survival.
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Summary
Korean summary
이 연구는 two-sample Mendelian randomization (MR)을 이용하여 대장암에서 C-reactive protein와 사망률 간의 관련성을 평가하였다. Two-sample MR은 한국유전체역학조사사업 (the Korean Genome and Epidemiology Study, KoGES) 참가자 59,605명에서 혈청 C-reactive protein에 대한 전장유전체 분석을 시행하여 7개의 단일염기다형성을 선별하였고, 화순암역학연구-대장암 (thw Hwasun Cancer Epidemiology Study-Colon and Rectum Cancer, HCES-CRC)에 등록된 6,460명 대장암 환자에서 그 7개 단일염기다형성과 사망률 간의 관련성을 평가한 결과를 이용하였다. 그 결과, 높은 혈청 C-reactive protein을 가지는 유전적 성향은 대장암 환자에서 사망률과의 통계적으로 유의한 관련성을 찾을 수 없었다.
Key Message
This study employed a two-sample Mendelian randomization (MR) analysis to investigate the relationship between serum C-reactive protein (CRP) levels and mortality in colorectal cancer. The analysis utilized genome-wide association analysis (GWAS) data from 59,605 participants in the Korean Genome and Epidemiology Study (KoGES) for serum CRP and 6,460 colorectal cancer cases from the Hwasun Cancer Epidemiology Study-Colon and Rectum Cancer for mortality. Our findings suggest that there is no statistically significant association between genetically predisposed serum CRP levels and mortality. Consequently, our study does not support a causal effect of CRP on mortality in colorectal cancer.
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Measles susceptibility of marriage migrant women in Korea
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Sooyeon Kim, Sun A Kim, Hanbich Hong, Seong Ryeong Choi, Hae-Young Na, Sung Un Shin, Kyung-Hwa Park, Sook In Jung, Min-Ho Shin, Sun-Seog Kweon, Seung Ji Kang
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Epidemiol Health. 2022;44:e2022031. Published online March 12, 2022
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DOI: https://doi.org/10.4178/epih.e2022031
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Abstract
International migrants could be considered a risk group susceptible to vaccine-preventable diseases. We conducted a measles seroprevalence study among 419 marriage migrant women living in Sinan-gun and Wando-gun, South Jeolla Province, located in the southwestern part of Korea. The overall seroimmunity was 92.8%. The seroimmunity varied considerably according to the country of origin and increased with age. Our current analysis could be valuable in the context of discussions concerning vaccination policies for immigrants in Korea.
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Summary
Korean summary
전라남도 신안군과 완도군에 거주하는 결혼이주여성 419명을 대상으로 홍역항체 양성률을 조사하였다. 전체적 항체양성률은 92.8% 로 높았으나, 나이로 나누어 분석하였을 때, 30세 미만에서는 83.1% 로 30세 이상의 95.5% 에 비해 통계적으로 유의미하게 낮았다. 출신국가에 따른 분석에서는 캄보디아 출신의 경우 30세 미만에서 항체 양성률이 40.0 % 에 불과하여, 타국가 들에 비해 통계적으로 유의미하게 낮았다.
Key Message
To prevent measles resurgence, continuous monitoring of immunity in communities, including foreign-born populations who may have different serostatus, is essential.
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No evidence of delay in colorectal cancer diagnosis during the COVID-19 pandemic in Gwangju and Jeonnam, Korea
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Hye-Yeon Kim, Min-Gyeong Kim, Mi-Ran Kang, Jeong-Ho Yang, Min-Ho Shin, Sun-Seog Kweon
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Epidemiol Health. 2022;44:e2022092. Published online October 17, 2022
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DOI: https://doi.org/10.4178/epih.e2022092
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Abstract
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Abstract
OBJECTIVES
We evaluated whether the coronavirus disease 2019 (COVID-19) pandemic caused delays in the diagnosis and treatment of colorectal cancer (CRC) in Korea, where there have been no regional or hospital lockdowns during the pandemic period.
METHODS Data on CRC patients (n=1,445) diagnosed in Gwangju Metropolitan City and Jeonnam Province between January 2019 and December 2021 were assessed. The stage at the time of CRC diagnosis, route to diagnosis, time to initial cancer treatment, and length of hospital admission were compared before and during the COVID-19 pandemic. Logistic regression was also performed to identify factors associated with the risk for diagnosis in an advanced stage.
RESULTS No negative effects indicating a higher CRC stage at diagnosis or delayed treatment during the pandemic were observed. Instead, the risk for an advanced stage at diagnosis (TNM stage III/IV) decreased in CRC patients diagnosed during the pandemic (odds ratio, 0.768; 95% confidence interval, 0.647 to 0.911). No significant differences in the interval from diagnosis to operation or chemotherapy were observed.
CONCLUSIONS No negative effects on CRC diagnosis and treatment were found until the end of 2021, which may be related to the small magnitude of the COVID-19 epidemic, the absence of a lockdown policy in Korea, and the rebound in the number of diagnostic colonoscopy procedures in 2021.
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Summary
Korean summary
COVID-19 판데믹 시기에 진단된 대장암환자에서 진단병기의 지연과 치료의 지연이 발생한 증거는 찾을 수 없었다. 이것은 2021년까지 한국에서는 유행규모가 크지 않았고, 의료기관 또는 지역단위의 봉쇄정책이 거의 없었기 때문일 것으로 추정된다.
Key Message
No evidence of delayed diagnosis and treatment of colorectal cancer was found during the COVID-19 pandemic period (2020-2021) in Gwangju-Jeonnam, Korea. It may be related to the small magnitude of the COVID-19 epidemic, the absence of a lockdown policy in Korea.
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