TNF and colorectal carcinoma: As another example, a study observed a higher level of tumor necrosis factor-alpha (TNF-alpha) in CRC patients, compared with healthy controls, while another study found no difference.[8,12] Given the ongoing debates regarding these circulating inflammatory cytokines and the inherent limitations in traditional observational studies,[13] it remained imperative to evaluate the potential causal relationships between circulating inflammatory cytokines with CRC.