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Serum total and HDL cholesterol and risk of prostate cancer

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Abstract

Background

Studies suggest a decreased risk of high-grade prostate cancer in men with lower circulating total cholesterol and that statins may protect against aggressive disease. Confirmation in additional populations and examination of associations for lipoprotein subfractions are needed.

Methods

We examined prostate cancer risk and serum total and HDL cholesterol in the ATBC Study cohort (n = 29,093). Cox proportional hazards models were used to estimate the relative risk of total (n = 2,041), non-aggressive (n = 829), aggressive (n = 461), advanced (n = 412), and high-grade (n = 231) prostate cancer by categories of total and HDL cholesterol.

Results

After excluding the first 10 years of follow-up, men with higher serum total cholesterol were at increased risk of overall (≥240 vs. <200 mg/dl: HR = 1.22, 95% CI 1.03–1.44, p-trend = 0.01) and advanced (≥240 vs. <200 mg/dl: HR = 1.85, 95% CI 1.13–3.03, p-trend = 0.05) prostate cancer. Higher HDL cholesterol was suggestively associated with a decreased risk of prostate cancer regardless of stage or grade.

Conclusions

In this population of smokers, high serum total cholesterol was associated with higher risk of advanced prostate cancer, and high HDL cholesterol suggestively reduced the risk of prostate cancer overall. These results support previous studies and, indirectly, support the hypothesis that statins may reduce the risk of advanced prostate cancer by lowering cholesterol.

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References

  1. Platz EA, Clinton SK, Giovannucci E (2008) Association between plasma cholesterol and prostate cancer in the PSA era. Int J Cancer 123(7):1693–1698

    Article  PubMed  CAS  Google Scholar 

  2. Platz EA, Till C, Goodman PJ, et al (2009) Men with low serum cholesterol have a lower risk of high grade prostate cancer in the Prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev (in press)

  3. Mondul AM, Clipp SL, Helzlsouer KJ, Platz EA (2010) Association between plasma total cholesterol concentration and incident prostate cancer in the CLUE II cohort. Cancer Causes Control 21(1):61–68. Available from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19806465

    Google Scholar 

  4. Shannon J, Tewoderos S, Garzotto M et al (2005) Statins and prostate cancer risk: a case-control study. Am J Epidemiol 162(4):318–325

    Article  PubMed  Google Scholar 

  5. Platz EA, Leitzmann MF, Visvanathan K et al (2006) Statin drugs and risk of advanced prostate cancer. J Natl Cancer Inst 98(24):1819–1825

    Article  PubMed  CAS  Google Scholar 

  6. Jacobs EJ, Rodriguez C, Bain EB, Wang Y, Thun MJ, Calle EE (2007) Cholesterol-lowering drugs and advanced prostate cancer incidence in a large US cohort. Cancer Epidemiol Biomarkers Prev: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 16(11):2213–2217

    Google Scholar 

  7. Murtola TJ, Tammela TL, Lahtela J, Auvinen A (2007) Cholesterol-lowering drugs and prostate cancer risk: a population-based case-control study. Cancer Epidemiol Biomarkers Prev: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 16(11):2226–2232

  8. Flick ED, Habel LA, Chan KA, et al (2007) Statin use and risk of prostate cancer in the California men’s health study cohort. Cancer Epidemiol Biomarkers Prev: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 16(11):2218–2225

    Google Scholar 

  9. Agalliu I, Salinas CA, Hansten PD, Ostrander EA, Stanford JL (2008) Statin use and risk of prostate cancer: results from a population-based epidemiologic study. Am J Epidemiol 168(3):250–260

    Article  PubMed  Google Scholar 

  10. Friedman GD, Flick ED, Udaltsova N, Chan Pharm DJ, Quesenberry CP Jr, Habel LA (2008) Screening statins for possible carcinogenic risk: up to 9 years of follow-up of 361 859 recipients. Pharmacoepidemiol Drug Saf 17(1):27–36

    Article  PubMed  Google Scholar 

  11. Kark JD, Smith AH, Hames CG (1982) Serum retinol and the inverse relationship between serum cholesterol and cancer. British Med J (Clinical research ed.) 284(6310):152–154

    Article  CAS  Google Scholar 

  12. Wallace RB, Rost C, Burmeister LF, Pomrehn PR (1982) Cancer incidence in humans: relationship to plasma lipids and relative weight. J Natl Cancer Inst 68(6):915–918

    PubMed  CAS  Google Scholar 

  13. Hiatt RA, Fireman BH (1986) Serum cholesterol and the incidence of cancer in a large cohort. J Chronic Dis 39(11):861–870

    Article  PubMed  CAS  Google Scholar 

  14. Knekt P, Reunanen A, Aromaa A, Heliovaara M, Hakulinen T, Hakama M (1988) Serum cholesterol and risk of cancer in a cohort of 39,000 men and women. J Clin Epidemiol 41(6):519–530

    Article  PubMed  CAS  Google Scholar 

  15. Thompson MM, Garland C, Barrett-Connor E, Khaw KT, Friedlander NJ, Wingard DL (1989) Heart disease risk factors, diabetes, and prostatic cancer in an adult community. Am J Epidemiol 129(3):511–517

    PubMed  CAS  Google Scholar 

  16. Chyou PH, Nomura AM, Stemmermann GN, Kato I (1992) Prospective study of serum cholesterol and site-specific cancers. J Clin Epidemiol 45(3):287–292

    Article  PubMed  CAS  Google Scholar 

  17. Smith GD, Shipley MJ, Marmot MG, Rose G (1992) Plasma cholesterol concentration and mortality. The whitehall study. JAMA J Am Med Assoc 267(1):70–76

    Article  CAS  Google Scholar 

  18. Schuit AJ, Van Dijk CE, Dekker JM, Schouten EG, Kok FJ (1993) Inverse association between serum total cholesterol and cancer mortality in dutch civil servants. Am J Epidemiol 137(9):966–976

    PubMed  CAS  Google Scholar 

  19. Steenland K, Nowlin S, Palu S (1995) Cancer incidence in the national health and nutrition survey I. Follow-up data: diabetes, cholesterol, pulse and physical activity. Cancer Epidemiol Biomarkers Prev: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology; Cancer epidemiology, biomarkers & prevention : a publication of the America(TRUNCATED) 4(8):807–811

  20. Eichholzer M, Stahelin HB, Gutzwiller F, Ludin E, Bernasconi F (2000) Association of low plasma cholesterol with mortality for cancer at various sites in men: 17-y follow-up of the prospective Basel study. Am J Clinl Nutr 71(2):569–574

    CAS  Google Scholar 

  21. Wuermli L, Joerger M, Henz S et al (2005) Hypertriglyceridemia as a possible risk factor for prostate cancer. Prostate Cancer Prostatic Dis 8(4):316–320

    Article  PubMed  CAS  Google Scholar 

  22. Bravi F, Scotti L, Bosetti C et al (2006) Self-reported history of hypercholesterolaemia and gallstones and the risk of prostate cancer. Ann Oncol: Official Journal of the European Society for Medical Oncology/ESMO 17(6):1014–1017

    Google Scholar 

  23. Magura L, Blanchard R, Hope B, Beal JR, Schwartz GG, Sahmoun AE (2008) Hypercholesterolemia and prostate cancer: a hospital-based case-control study. Cancer Causes Control 19(10):1259–1266. Available from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18704722

  24. Martin RM, Vatten L, Gunnell D, Romundstad P, Nilsen TI (2009) Components of the metabolic syndrome and risk of prostate cancer: the HUNT 2 cohort, Norway. Cancer Causes Control 20(7):1181–1192. Available from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19277881

  25. Tuohimaa P, Tenkanen L, Syvala H, et al (2007) Interaction of factors related to the metabolic syndrome and vitamin D on risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 16(2):302–307. Available from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17301263

    Google Scholar 

  26. Van Hemelrijck M, Walldius G, Jungner I, et al (2011) Low levels of apolipoprotein A-I and HDL are associated with risk of prostate cancer in the Swedish AMORIS study. Cancer Causes Control 22(7):1011–1019. Available from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21562751

  27. Ahn J, Lim U, Weinstein SJ, et al (2009) Prediagnostic total and high-density lipoprotein cholesterol and risk of cancer. Cancer Epidemiol Biomarkers Prev 18(11):2814–2821. Available from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19887581

    Google Scholar 

  28. Korhonen P, Malila N, Pukkala E, Teppo L, Albanes D, Virtamo J (2002) The finnish cancer registry as follow-up source of a large trial cohort–accuracy and delay. Acta Oncol 41(4):381–388. Available from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12234031

    Google Scholar 

  29. Edwards JE, Moore RA (2003) Statins in hypercholesterolaemia: a dose-specific meta-analysis of lipid changes in randomised, double blind trials. BMC Fam Pract 4:18

    Article  PubMed  Google Scholar 

  30. Solomon KR, Freeman MR (2008) Do the cholesterol-lowering properties of statins affect cancer risk? Trends Endocrinol Metab TEM 19(4):113–121

    Article  CAS  Google Scholar 

  31. Kwiterovich PO Jr (2000) The metabolic pathways of high-density lipoprotein, low-density lipoprotein, and triglycerides: a current review. Am J Cardiol 86(12A):5L–10L. Available from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11374859

  32. Sekine Y, Demosky SJ, Stonik JA, et al (2010) High-density lipoprotein induces proliferation and migration of human prostate androgen-independent cancer cells by an ABCA1-dependent mechanism. Mol Cancer Res 8(9):1284–1294. Available from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20671065

    Google Scholar 

  33. Ciatto S, Zappa M, Villers A, Paez A, Otto SJ, Auvinen A (2003) Contamination by opportunistic screening in the European randomized study of prostate cancer screening. BJU Int 92(Suppl 2):97–100. Available from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=14983964

    Google Scholar 

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Acknowledgments

This work was supported by US Public Health Service contracts from the National Cancer Institute, Department of Health and Human Services (N01-CN-45165, N01-RC-45035, N01-RC-37004, and HHSN261201000006C); and by funding from the Intramural Research Program of the National Cancer Institute.

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Correspondence to Alison M. Mondul.

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Mondul, A.M., Weinstein, S.J., Virtamo, J. et al. Serum total and HDL cholesterol and risk of prostate cancer. Cancer Causes Control 22, 1545–1552 (2011). https://doi.org/10.1007/s10552-011-9831-7

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  • DOI: https://doi.org/10.1007/s10552-011-9831-7

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