Plasma ghrelin is probably not a useful biomarker for risk prediction or early detection of colorectal cancer

A recent study by Murphy et al reported an intriguing, time-dependent relationship between ghrelin, an appetite-stimulating hormone, and colorectal cancer (CRC).1 In the 10 years prior to diagnosis, but not earlier, low serum ghrelin concentrations were associated with a dramatic increase in CRC risk (OR=10.86). This raises the question of whether ghrelin might be a candidate biomarker for clinical use. However, whether ghrelin levels actually go down during the period approaching diagnosis is challenging to assess, requiring repeated prediagnostic blood samples from patients.

We conducted a validation of the study by Murphy et al1 using fasting plasma samples from the Västerbotten Intervention Programme, collected from CRC cases and matched controls within the 5 years preceding diagnosis of the cases. All participants had provided an additional blood sample 10 years earlier. This unique study design, described in detail elsewhere,2 allowed us to investigate potential changes in ghrelin...

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