{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:13:45Z","timestamp":1782126825686,"version":"3.54.5"},"reference-count":53,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Remnant cholesterol (RC), a marker of triglyceride\u2010rich lipoproteins, has been implicated in cardiovascular disease via inflammatory pathways, but its role in cancer development remains unclear. This study investigated the independent and joint effects of RC and systemic inflammation on long\u2010term cancer risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors analyzed data from 136,158 participants in the Kailuan cohort who were free from cancer and cardiovascular disease at baseline. RC was calculated as total cholesterol minus high\u2010density lipoprotein cholesterol and low\u2010density lipoprotein cholesterol. High\u2010sensitivity C\u2010reactive protein (hs\u2010CRP) was used to assess systemic inflammation. Incident cancer cases were identified during a median follow\u2010up of 16.18 years. Cox proportional hazards models, interaction analyses, mediation analysis, and cross\u2010lagged panel models were used to assess the relationships between RC, hs\u2010CRP, and cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 7080 incident cancers were recorded. Compared with the lowest quartile of RC (Q1), participants in the highest quartile (Q4) had a significantly increased risk of overall cancer (hazard ratio [HR], 1.188; 95% confidence interval [CI], 1.108\u20131.273), lung cancer (HR,\u00a01.349; 95% CI, 1.179\u20131.543), and colorectal cancer (HR, 1.775; 95% CI, 1.443\u20132.184). Participants with both high RC and high hs\u2010CRP had the highest risk (HR, 1.332; 95% CI, 1.268\u20131.400). Mediation analysis revealed that RC mediated 8.31% of the hs\u2010CRP\u2013cancer relationship, and vice versa. Cross\u2010lagged models confirmed a bidirectional temporal association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RC and systemic inflammation act synergistically and bidirectionally to increase cancer risk, supporting a metabolic\u2013inflammatory axis in carcinogenesis. These findings identify novel, potentially modifiable targets for early cancer risk stratification and prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70096","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T13:42:08Z","timestamp":1758202928000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Remnant cholesterol and systemic inflammation as synergistic predictors of cancer risk: A 16\u2010year prospective cohort study"],"prefix":"10.1002","volume":"131","author":[{"given":"Hongxue","family":"Xu","sequence":"first","affiliation":[{"name":"School of Public Health North China University of Science and Technology  Tangshan China"},{"name":"College of Life Sciences North China University of Science and Technology  Tangshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peipei","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Public Health North China University of Science and Technology  Tangshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuohua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kailuan General Hospital  Tangshan Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guodong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kailuan General Hospital  Tangshan Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7095-6022","authenticated-orcid":false,"given":"Shouling","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kailuan General Hospital  Tangshan Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health North China University of Science and Technology  Tangshan China"},{"name":"College of Life Sciences North China University of Science and Technology  Tangshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(24)00757\u20108"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654\u2010024\u201001175\u20109"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.EPI\u201016\u20100647"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addr.2020.07.013"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2012.12.030"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416\u2010024\u201002900\u20107"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416\u2010020\u201001143\u20106"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120\u2010024\u201001477\u20107"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618\u2010023\u201002153\u2010w"},{"issue":"3","key":"e_1_2_10_12_1","first-page":"975","article-title":"The association and joint effect of serum cholesterol, glycemic status with the risk of incident cancer among middle\u2010aged and elderly population in china cardiometabolic disease and cancer cohort (4C)\u2010study","volume":"10","author":"Li M","year":"2020","journal-title":"Am J Cancer Res"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOL.0000000000000429"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.113.003008"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.116.308834"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008\u20105472.CAN\u201013\u20102322"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.1040163"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2019.06.025"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.Epi\u201023\u20101145"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010021\u201020935\u20109"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1042\/CS20201394"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2017.09.024"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcb.2024.01.004"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmet.2021.101349"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12944\u2010024\u201002241\u20107"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12937\u2010024\u201000951\u20103"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.963694"},{"issue":"6","key":"e_1_2_10_28_1","first-page":"469","article-title":"[The risk predictive value of high sensitivity C\u2010reactive protein level for new hemorrhagic stroke events]","volume":"49","author":"Zhu J","year":"2010","journal-title":"Zhonghua Nei Ke Za Zhi"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.120.010953"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2024.131946"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.124.046811"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.121.037756"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933\u2010024\u201002556\u2010w"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.622514"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010017\u20104401\u20105"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.595835"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.4062\/biomolther.2023.132"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2010.08.007"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms241512032"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.21436"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010020\u201001855\u20109"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19137804"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605264"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc.2016.30"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.6530"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010018\u201008159\u2010w"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13167\u2010019\u201000194\u2010x"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10555\u2010022\u201010054\u20102"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djac193"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010023\u201005874\u20103"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpt.2025.04.002"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.1042729"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.6001\/actamedica.v25i4.3929"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2017.96"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70096","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T18:42:24Z","timestamp":1761763344000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.70096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,18]]},"references-count":53,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/cncr.70096"],"URL":"https:\/\/doi.org\/10.1002\/cncr.70096","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,18]]},"assertion":[{"value":"2025-06-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70096"}}