Association between C-reactive protein level and subsequent risk of ovarian cancer: A meta-analysis of 13 cohorts in 1,852 ovarian cancer patients

BACKGROUND: Though studies have shown association between C-reactive protein (CRP) level and the risk of ovarian cancer (OC), there have been some inconsistencies. The current metaanalysis was conducted to study the relationship between CRP and OC. PATIENTS AND METHODS: Three electronic databases of PubMed, Embase, and Cochrane Library were searched for prospective studies of OC from inception till May 2018. Relative risk (RR) was summarized using random-effects model, and the results of sensitivity, subgroup analyses, and publication biases were also calculated. RESULTS: A total of 13 cohorts involving 1,852 OC patients were included for the final meta-analysis. The summary RRs indicated that high CRP was associated with an increased risk of all invasive OC (RR:1.36; 95% confidence interval [CI]:1.03–1.80; P = .032), while moderate CRP showed no significant impact on the risk of all invasive OC compared with low CRP (RR:1.17; 95% CI:0.97–1.41; P = .107). High (RR: 1.42; 95% CI: 0.85–2.37; P = .183) or moderate (RR: 1.29; 95% CI: 0.94–1.77; P = .119) CRP levels showed little or no effect on serous OC. Similarly, no significant differences for the comparisons of high versus low (RR: 1.82; 95% CI: 0.27–12.42; P = .540) or moderate versus low (RR: 0.72; 95% CI: 0.31–1.69; P = .455) CRP levels for the risk of mucinous OC were observed. Moreover, high (RR: 0.58; 95% CI: 0.13–2.54; P = .471) or moderate (RR: 0.81; 95% CI: 0.44–1.47; P = .484) CRP levels were not associated with the risk of endometrioid OC compared with low CRP levels. CONCLUSION: High CRP levels were associated with increased risk of invasive OC. The risk of other OC types with CRP levels showed no association.