Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026
A Composite Low-Grade Inflammation Score and Cancer Outcomes: Results from the Moli-sani Study.
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Costanzo Simona, Di Castelnuovo Augusto, Bonaccio Marialaura, Magnacca Sara, Panzera Teresa, De Curtis Amalia, Bracone Francesca, Martinelli Giulia, Parisi Roberta, Cerletti Chiara, Donati Maria Benedetta, de Gaetano Giovanni, Iacoviello Licia, Moli-sani Study investigators
Аннотация
BACKGROUND: Epidemiologic evidence links low-grade inflammation to an increased risk of chronic degenerative diseases, but its relationship with cancer remains controversial. This study aimed to investigate the association between a composite low-grade inflammation score and different cancer outcomes on a large epidemiologic scale.
METHODS: A prospective analysis was conducted among 18,933 individuals (51.8% women; age ≥35 years) free of cancer, chronic inflammation, or hematologic diseases from the Moli-sani cohort. Low-grade inflammation was assessed using the INFLA-score, derived from C-reactive protein, granulocyte-to-lymphocyte ratio, and leukocyte and platelet counts. Hazard ratios (HR) and 95% confidence intervals (CI) for cancer mortality, cancer-related hospitalization, and colorectal cancer were estimated across INFLA-score fifths using multivariable Cox proportional hazard models.
RESULTS: During a 13.1-year follow-up, 612 cancer deaths, 1,854 cancer-related hospitalizations, and 287 colorectal cancer cases were ascertained. Individuals in the highest INFLA-score fifth showed higher hazard of cancer mortality (HRQ5vsQ1-Q4: 1.19; 95% CI, 0.99-1.44), cancer-related hospitalization (1.21; 1.08-1.34), and colorectal cancer (1.68; 1.30-2.18), compared with lowest fifths, independently of health-related behaviors and chronic diseases. Associations were more pronounced for cancer mortality and hospitalization in older individuals and those with a cancer family history and for colorectal cancer among women (all P for interaction >0.05). Increased cancer mortality hazard was observed among normal-weight and overweight individuals but not in obese individuals (P for interaction = 0.039).
CONCLUSIONS: Higher INFLA-score is associated with increased hazard of cancer hospitalization and colorectal cancer.
IMPACT: Subclinical inflammation may be a prognostic indicator for cancer, underscoring the potential role of lifestyle interventions and systemic inflammation monitoring in cancer prevention.
METHODS: A prospective analysis was conducted among 18,933 individuals (51.8% women; age ≥35 years) free of cancer, chronic inflammation, or hematologic diseases from the Moli-sani cohort. Low-grade inflammation was assessed using the INFLA-score, derived from C-reactive protein, granulocyte-to-lymphocyte ratio, and leukocyte and platelet counts. Hazard ratios (HR) and 95% confidence intervals (CI) for cancer mortality, cancer-related hospitalization, and colorectal cancer were estimated across INFLA-score fifths using multivariable Cox proportional hazard models.
RESULTS: During a 13.1-year follow-up, 612 cancer deaths, 1,854 cancer-related hospitalizations, and 287 colorectal cancer cases were ascertained. Individuals in the highest INFLA-score fifth showed higher hazard of cancer mortality (HRQ5vsQ1-Q4: 1.19; 95% CI, 0.99-1.44), cancer-related hospitalization (1.21; 1.08-1.34), and colorectal cancer (1.68; 1.30-2.18), compared with lowest fifths, independently of health-related behaviors and chronic diseases. Associations were more pronounced for cancer mortality and hospitalization in older individuals and those with a cancer family history and for colorectal cancer among women (all P for interaction >0.05). Increased cancer mortality hazard was observed among normal-weight and overweight individuals but not in obese individuals (P for interaction = 0.039).
CONCLUSIONS: Higher INFLA-score is associated with increased hazard of cancer hospitalization and colorectal cancer.
IMPACT: Subclinical inflammation may be a prognostic indicator for cancer, underscoring the potential role of lifestyle interventions and systemic inflammation monitoring in cancer prevention.