Pre-Surgery Inflammatory and Angiogenesis Biomarkers as Predictors of 12-Month Cancer-Related Distress: Results from the ColoCare Study

Clara L. Lindley, Biljana Gigic, Anita R. Peoples, Claire J. Han, Tengda Lin, Caroline Himbert, Christy A. Warby, Juergen Boehm, Sheetal Hardikar, Anjelica Ashworth, Martin Schneider, Alexis Ulrich, Petra Schrotz-King, Jane C. Figueiredo, Christopher I. Li, David Shibata, Erin M. Siegel, Adetunji T. Toriola, Cornelia M. Ulrich, Karen L. SyrjalaJennifer Ose

Research output: Contribution to journalArticlepeer-review


Background: Patients with colorectal cancer commonly suffer from complex psychological distress. Elevated distress may be linked to systemic biomarkers. We investigated associations of biomarkers of inflammation and angiogenesis with cancer-related distress (CTXD) score. Methods: N = 315 patients (stage I–IV) from 2 centers of the ColoCare Study were included: Huntsman Cancer Institute and University of Heidelberg. Biomarkers (e.g., IL6, VEGF-A, VEGF-D) were measured in serum collected pre-surgery and 12 months thereafter. The CTXD overall score and 4 subscales were collected 12 months after surgery and dichotomized to investigate biomarkers as predictors of distress 12 months after surgery; adjusted for age, sex, body mass index, tumor stage, center, and baseline levels of biomarkers. Results: Doubling of IL6 predicted future increased risk of overall distress [odds ratio (OR), 1.20; 95% confidence interval (CI), 1.02–1.41; P = 0.03]. VEGF-A–predicted future increased risk of high family strain (VEGF-A: OR, 1.21; 95% CI, 1.01–1.44; P = 0.04) and VEGF-D was associated with medical and financial demands (OR, 1.34; 95% CI, 1.01–1.74; P = 0.03). Conclusions: This is the first study to show that systemic biomarkers are significantly associated with future CTXD score. Distress was not measured at baseline; we cannot rule out ongoing associations of inflammation and distress throughout treatment versus a direct effect of inflammation on distress. Nonetheless, these data add to evidence that biobehavioral processes interact and that systemic biomarkers are associated with cancer-related distress one year after surgery.

Original languageEnglish
Pages (from-to)363-370
Number of pages8
JournalCancer Epidemiology Biomarkers and Prevention
Issue number3
StatePublished - Mar 1 2023


Dive into the research topics of 'Pre-Surgery Inflammatory and Angiogenesis Biomarkers as Predictors of 12-Month Cancer-Related Distress: Results from the ColoCare Study'. Together they form a unique fingerprint.

Cite this