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. 2009 Jun;20(6):1113-20.
doi: 10.1093/annonc/mdn736. Epub 2009 Jan 22.

Time-dependent association of total serum cholesterol and cancer incidence in a cohort of 172,210 men and women: a prospective 19-year follow-up study

A M Strasak  1 , R M Pfeiffer, L J Brant, K Rapp, W Hilbe, W Oberaigner, S Lang, W Borena, H Concin, G Diem, E Ruttmann, B Glodny, K P Pfeiffer, H Ulmer; VHM&PP Study Group
Collaborators, Affiliations

Time-dependent association of total serum cholesterol and cancer incidence in a cohort of 172,210 men and women: a prospective 19-year follow-up study

A M Strasak et al. Ann Oncol. 2009 Jun.

Abstract

Background: The relationship between serum cholesterol and cancer incidence remains controversial.

Patients and methods: We investigated the association of total serum cholesterol (TSC) with subsequent cancer incidence in a population-based cohort of 172 210 Austrian adults prospectively followed up for a median of 13.0 years. Cox regression, allowing for time-dependent effects, was used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) for the association of TSC with cancer.

Results: We observed pronounced short-term associations of TSC and overall cancer incidence in both men and women. For malignancies diagnosed shortly (<5 months) after baseline TSC measurement, the highest TSC tertile (>235.0 mg/dl in men and >229.0 in women) compared with the lowest tertile (<194.0 mg/dl in men and <190.0 in women) was associated with a significantly lower overall cancer risk [HR = 0.58 (95% CI 0.43-0.78, P(trend) = 0.0001) in men, HR = 0.69 (95% CI 0.49-0.99, P(trend) = 0.03) in women]. However, after roughly 5 months from baseline measurement, overall cancer risk was not significantly associated with TSC. The short-term inverse association of TSC with cancer was mainly driven by malignancies of the digestive organs and lymphoid and hematopoietic tissue.

Conclusion: The short-term decrease of cancer risk seen for high levels of TSC may largely capture preclinical effects of cancer on TSC.

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Figures

Figure 1.
Figure 1.
Panels A and B. Hazard function plot for overall cancer incidence by tertiles of total serum cholesterol (TSC) in 79 417 men (Panel A) and 92 793 women (Panel B) in the Vorarlberg Health Monitoring and Promotion Program, 1985–2003.
See this image and copyright information in PMC

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