Is C-reactive protein specific for vascular disease in women?

C-reactive protein (CRP) predicts risk for future cardiovascular events in asymptomatic individuals. However, because CRP also predicts total mortality, its specificity for vascular disease is uncertain. To compare the predictive value of CRP for cancer and cardiovascular disease, the major determinants of mortality. Prospective, nested case-control study. The Women's Health Study, an ongoing prospective cohort study involving 28345 U.S. women 45 years of age and older who were healthy at the time of enrollment. 643 women who subsequently developed cancer or had cardiovascular events; 643 age- and smoking-matched women who remained free of either disease during 58-month follow-up. Baseline CRP levels. Little evidence showed that increasing quartiles of baseline CRP predicted incident cancer (adjusted relative risks, 1.0, 1.2, 1.1, and 1.3; P for trend > 0.2). In contrast, increasing quartiles of baseline CRP were a strong marker of risk for future cardiovascular disease (adjusted relative risks, 1.0, 2.9, 3.4, and 5.6; P for trend < 0.001). C-reactive protein appears to independently predict cardiovascular events but not cancer.