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Association between plasma total cholesterol concentration and incident prostate cancer in the CLUE II cohort

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Abstract

Statin drugs appear to protect against advanced and possibly high-grade prostate cancer, perhaps through cholesterol-lowering. Thus, we evaluated the association between plasma cholesterol and prostate cancer. We conducted a prospective study in the CLUE II cohort of Washington County, MD. Included were 6,816 male county residents aged 35+ years old who did not have a cancer diagnosis at baseline in 1989. Plasma cholesterol, measured enzymatically at baseline, was categorized by clinical cutpoints. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for total (n = 438) and high-grade (Gleason sum ≥7, n = 137) prostate cancer. Compared to men with high cholesterol (≥240 mg/dl), men with desirable (<200 mg/dl) or borderline (200 to <240 mg/dl) levels were less likely to develop high-grade prostate cancer, particularly when restricting to organ-confined cases (HR: 0.68, 95% CI 0.40–1.18; P trend = 0.12) and among men with higher BMI (HR: 0.36, 95% CI 0.16–0.79; P trend = 0.02). Results were unchanged after excluding cholesterol-lowering drug users. Cholesterol was not associated with total prostate cancer. Our study supports two prior ones suggesting that cholesterol influences risk of high-grade prostate cancer, and indirectly supports the hypothesis that cholesterol-lowering is a mechanism by which statins are protective.

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References

  1. 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  CAS  PubMed  Google Scholar 

  2. Mondul AM, Walsh PC, Platz EA (2007) Association of statin use with pathologic findings on prostatectomy and prostate cancer progression. In: American association for cancer research annual meeting proceedings. American Association for Cancer Research

  3. 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 

  4. 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 16(11):2218–2225

    Article  CAS  PubMed  Google Scholar 

  5. Jacobs EJ, Rodriguez C, Bain EB et al (2007) Cholesterol-lowering drugs and advanced prostate cancer incidence in a large U.S. cohort. Cancer Epidemiol Biomarkers Prev 16(11):2213–2217

    Google Scholar 

  6. 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 16(11):2226–2232

    Article  CAS  PubMed  Google Scholar 

  7. Friedman GD, Flick ED, Udaltsova N et al (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 

  8. 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 

  9. Feinleib M (1982) Summary of a workshop on cholesterol and noncardiovascular disease mortality. Prev Med 11(3):360–367

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  Google Scholar 

  11. 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

    CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  13. Knekt P, Reunanen A, Aromaa A et al (1988) Serum cholesterol and risk of cancer in a cohort of 39, 000 men and women. J clin epidemiol 41(6):519–530

    Article  CAS  PubMed  Google Scholar 

  14. Thompson MM, Garland C, Barrett-Connor E et al (1989) Heart disease risk factors, diabetes, and prostatic cancer in an adult community. Am J Epidemiol 129(3):511–517

    CAS  PubMed  Google Scholar 

  15. Chyou PH, Nomura AM, Stemmermann GN, Kato I (1992) Prospective study of serum cholesterol and site-specific cancers. J Clin Epidemiol 45(3):287–92

    Google Scholar 

  16. Smith GD, Shipley MJ, Marmot MG, Rose G (1992) Plasma cholesterol concentration and mortality. The Whitehall study. JAMA 267(1):70–76

    Google Scholar 

  17. 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

    Google Scholar 

  18. 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 4(8):807–811

    Google Scholar 

  19. 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 Clin Nutr 71(2):569–574

    Google Scholar 

  20. Mydlo JH, Tieng NL, Volpe MA, Chaiken R, Kral JG (2001) A pilot study analyzing PSA, serum testosterone, lipid profile, body mass index and race in a small sample of patients with and without carcinoma of the prostate. Prostate Cancer Prostatic Dis 4(2):101–105

    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  CAS  PubMed  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 (6):1014–1017

  23. 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

    Google Scholar 

  24. 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)

  25. Block G, Hartman AM, Dresser CM et al (1986) A data-based approach to diet questionnaire design and testing. Am J Epidemiol 124(3):453–469

    CAS  PubMed  Google Scholar 

  26. Kwiterovich PO Jr, White S, Forte T et al (1987) Hyperapobetalipoproteinemia in a kindred with familial combined hyperlipidemia and familial hypercholesterolemia. Arteriosclerosis 7(3):211–225

    PubMed  Google Scholar 

  27. American Heart Association (2008) What your cholesterol levels mean. American Heart Association, Dallas

    Google Scholar 

  28. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL (1998) Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 22(1):39–47

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

Dr. Mondul was supported by a National Research Service Award (T32 CA009314) from the National Cancer Institute, National Institutes of Health. Funding for the CLUE II Cohort has been provided by grants from the National Cancer Institute (U01 CA086308) and the National Institute of Aging (U01 AG18033), National Institutes of Health. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

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Correspondence to Elizabeth A. Platz.

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Mondul, A.M., Clipp, S.L., Helzlsouer, K.J. et al. Association between plasma total cholesterol concentration and incident prostate cancer in the CLUE II cohort. Cancer Causes Control 21, 61–68 (2010). https://doi.org/10.1007/s10552-009-9434-8

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  • DOI: https://doi.org/10.1007/s10552-009-9434-8

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