Abstract
At the preceding Bologna meeting, evidence was presented that measures to prevent coronary heart disease (CHD) are likely to provide protection against some of the other, major chronic diseases as well [1]. Of the latter, the most important is cancer in its different manifestations. During the last few years, a high level of consensus has been reached that CHD is, indeed, preventable through risk factor control and that both a population and a high-risk strategy are needed to make prevention optimally effective on the population level [2–6]. However, there is still opposition to these recommendations, even though they become more and more accepted by the scientific and medical community.The most serious of these objections is the allegation that the reduction in CHD risk resulting from lowering one of the three main risk factors, serum cholesterol, would be counterbalanced by an increase in cancer risk, leaving total mortality unchanged [7]. It is the present purpose to show that these concerns are unfounded, based on a comprehensive review of available data, bearing both on cancer and total mortality.
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References
Epstein,F.H. (1986) ‘Prevention of coronary heart disease-links with other chronic disorders’, in S. Lenzi and G.C. Descovich eds., Atherosclerosis and Cardiovascular Diseases, MTP Press Ltd. Lancaster, Boston, The Hague, Dordrecht, pp. 157–162.
Prevention of coronary heart disease’ (1982) Report of a W.H.O. Expert Committee, Technical Report Series 678, World Health Organization, Geneva, Switzerland.
Study Group, European Atherosclerosis Society (1987) ‘Strategies for the prevention of coronary heart disease’, Europ.Heart J. 8, 77–88.
Study Group, European Atherosclerosis Society (1988) ‘The recognition and management of hyperlipidaemia in adults: a policy statement of the European Atherosclerosis Society’, Europ.Heart J. 9, 571–600.
The Expert Panel (1988) ‘Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults’, Arch.Int.Med. 148, 36–69.
Havel,R.J. (1988) ‘Lowering cholesterol, 1988, rationale, mechanisms and means’, J.Qin.Invest. 81, 1653–1660.
Oliver,M.F. (1988) ‘Reducing cholesterol does not reduce mortality’, J.Am.Coll.Cardiol. 12, 814–817.
Ederer,F. et al. (1971) ‘Cancer among men on cholesterol-lowering diets. Experience from clinical trials’, Lancet 2, 203–206.
Anon (1981) ‘Cholesterol and non-cardiovascular mortality’, J.Am.Med.Ass. 246, 731.
Workshop on cholesterol, and non-cardiovascular disease mortality’, National Heart, Lung and Blood Institute and National Cancer Institute, National Institutes of Health, Bethesda, Maryland, U.S.A., May 11–12, 1981.
Cambien,F., Ducimetière,P. and Richard,J. (1980) ‘Total serum cholesterol and cancer mortality in a middle-aged male population’, Am. J.Epidemiol. 112, 388–394.
Rose,G. and Shipley,M.J. (1980) ‘Plasma lipids and mortality: a source of error’, Lancet 1, 523–525.
Wallace,R.B. et al. (1982) ‘Cancer incidence in humans: relationships to plasma lipids and relative weight’, J.Nat.Cancer Inst. 68, 915–918.
International Collaborative Group (1982) ‘Circulating cholesterol level and risk of death from cancer in men aged 40 to 69 years’, J.Am.Med. Ass. 248, 2853–2859.
Hiatt,R.A. and Firemen,B.H. (1986) ‘Serum cholesterol and the incidence of cancer in a large cohort’, J.Chronic Dis. 39, 861–870.
Sherwin,R.W. et al. (1987) ‘Serum cholesterol levels and cancer mortality in 361 662 men screened for the multiple risk factor intervention trial’, J.Am.Med.Ass. 257, 943–948.
Knekt,P. et al. (1988) ‘Serum cholesterol and risk of cancer in a cohort of 39,000 men and women’, J.Clin.Epidemiol. 41, 519–530.
KarkJ.D., Smith,A.H. and Hames,C.G. (1980) ‘The relationship of serum cholesterol to the incidence of cancer in Evans County, Georgia’, J.Chronic Dis. 33, 311–322.
Beaglehole,R. et al. (1980) ‘Cholesterol and mortality in New Zealand Maoris’, Brit.Med.J. 1, 285–287.
Garcia-Palmieri,M.R. (1981) ‘An apparent inverse relationship between serum cholesterol an cancer mortality in Puerto Rico’, Am.J.Epidemiol. 114, 29–40.
Kagan,A. et al (1981) ‘Serum cholesterol and mortality in a Japanese-American population’, Am. J.Epidemiol. 114, 11–20.
Williams,R.R. et al. (1981) ‘Cancer incidence by level of cholesterol’ (Framingham Study), J.Am.Med.Ass. 245,247–252.
BottigerJL.E. and Carlson,L.A. (1982) ‘Risk factors for death for males and females’, Acta Med.Scand. 211, 437–442.
Petersen,B., Trell,E. and Sternby,N.H. (1981) ‘Low cholesterol level as risk factor for noncoronary death in middle-aged men’, J.Am.Med.Ass. 245, 2056–2057.
Gerhardsson,M. et al. (1986) ‘Serum cholesterol and cancer - a retrospective case-control study’, Int.J.Epidemiol. 15, 155–159.
Schatzkin,A. et al. (1988) ‘Site-specific analysis of total serum cholesterol and incident cancer in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study’, Cancer Research 48, 452–458.
Isles,C.G. et al. (1989) ‘Plasma cholesterol, coronary heart disease, and cancer in the Renfrew and Paisley survey’, Brit.Med.J. 298, 920–924.
Kozarevic,D. et al. (1981) ‘Serum cholesterol and mortality. The Yugoslavia Cardiovascular Disease Study’, Am. J.Epidemiol. 114, 21–28.
Keys,A. et al. (1985) ‘Serum cholesterol and cancer mortality in the Seven Countries Study’, Am.J.Epidemiol. 121, 870–883.
,K. and Nicolaysen,R. (1972) ‘Ten-year mortality and morbidity related to serum cholesterol’, Scand.J.Clin.Labor.Invest. 30, Suppl. 127, 3–24.
SalonenJ. (1982) ‘Risk of cancer and death in relation to serum cholesterol’, Am.J.Epidemiol. 116, 622–630.
Dyer,A.R. et al. (1981) ‘Serum cholesterol and risk of death from cancer and other causes in three Chicago epidemiological studies’, J.Chronic Dis. 34, 249–620.
Thomas,C.B., Duszynski,K.R. and Schaffer,J.W. (1982) ‘Cholesterol levels in young adulthood and subsequent cancer: a preliminary note’, Johns Hopkins Med.J. 150, 89–94.
Wingard,D.L. et al. (1984) ‘Plasma cholesterol and cancer morbidity and mortality in an adult community’, J.Chronic Dis. 37, 401–406.
Yaari,S. et al. (1981) ‘Associations of high density lipoprotein and total cholesterol with total cardiovascular, and cancer mortality in a 7-year prospective study of 10,000 men’, Lancet 1, 1013–1015.
Morris,D.L. et al. (1983) ‘Serum cholesterol an cancer in the Hypertension Detection and Follow-up Program’, Cancer 52, 1754–1759.
Törnberg,S.A. et al. (1986) ‘Risk of cancer of the colon and rectum in relation to serum cholesterol and betalipoprotein’, New Eng.J.Med. 315, 1629–1633.
Mannes,G.A. et al. (1986) ‘Relation between the frequency of colorectal adenoma and the serum cholesterol level’, New Eng.J.Med. 315, 1634–1638.
Rose,G. et al. (1974) ‘Colon cancer and blood-cholesterol’, Lancet 1, 181–183.
Stemmermann,G.N. et al. (1981) ‘Serum cholesterol and colon cancer incidence in Hawaian Japanese men’, J.Nat.Cancer Inst. 67, 1179–1182.
Sorlie,P.D. and Feinleib,M. (1982) ‘The serum cholesterol-cancer relationship: an analysis of time trends in the Framingham Study’, J.Nat.Cancer Inst. 69, 989–996.
Davis,C.E. et al (1983) ‘Serum cholesterol and cancer mortality: Evans County 20-year follow-up study’, in: E.G.Perkins, W.J.Visek, eds., Dietary Fats and Health, Am. Oil Chemists Soc., Champaign, Illinois, pp. 892–900.
Sydney,S. and Farquhar,J.W. (1983) ‘Cholesterol, cancer, and public health policy’, Am.J.Med. 75, 494–508.
Keys,A. (1980) Seven Countries - A Multivariate Analysis of Death and Coronary Heart Disease, Harvard University Press, Cambridge, Mass. and London.
Yusuf,S. and Furberg,C.D. (1987) ‘Single factor trials’, in: A.G.Olsson,ed.,Atherosclerosis - Biology and Clinical Science, Churchill Livingstone, Edinburgh, London, Melbourne and New York, pp. 389–398.
Yusuf,S., Wittes,J. and Friedman,L. (1989) ‘Randomized clinical trials in heart disease’, J.Am.Med.Ass., 261, 2953–2954 (letter to the Editor).
Yusuf,S., Wittes,J. and Friedman,L. (1988) ‘Overview of results of randomized clinical trials in heart disease, II’ J.Am.Med.Ass. 260, 2259–2263.
Dayton,S. et al. (1969) ‘A controlled trial of a diet high in unsaturated fat’, Circulation 40 (Suppl.II) 1–62.
Frantz,I.D., Jr. et al. (1989) ‘Test of effect of lipid lowering by diet on cardiovascular risk’, Arteriosclerosis 9, 129–135.
Hjerman,I. et al. (1981) ‘Effect of diet and smoking intervention on the incidence of coronary heart disease’, Lancet 2, 1303–1310.
Committee of Principal Investigators (1980) ‘WHO Cooperative Trial on primary prevention of ischaemic heart disease using clofrbrate to lower serum cholesterol: mortality follow-up’, Lancet 2, 379–385.
Lipid Research Clinics Program (1984) ‘The Lipid Research Clinics Coronary Primary Prevention Trial results’, J.Am.Med.Ass. 251, 351–364.
Frick,M.H. (1987) ‘Helsinki Heart Study: primary prevention trial with gemfibrozil in middle-aged men with dyslipidemia’, New Eng.J.Med. 317,1237–1245.
Multiple Risk Factor Intervention Trial Research Group (1982) ‘Multiple risk factor intervention trial. Risk factor changes and mortality results’, J.Am.Med.Ass. 284, 1465–1477.
WHO European Collaborative Group (1986) ‘European Collaborative Trial of multifactorial prevention of coronary heart disease: final report on the 6-year results’, Lancet 1, 869–872.
Wilhelmsen,L. et al. (1986) ‘The multifactor primary prevention trial in Göteborg, Sweden’, Europ.Heart J. 7, 279–288.
Miettinen,T.A. et al. (1985) ‘Multifactorial primary prevention of cardiovascular diseases in middle-aged men’, J.Am.Med.Ass. 254, 2097–2102.
Rose,G. (1987) ‘European Collaborative Trial of multifactorial prevention of coronary heart disease’, Lancet 1, 685 (letter to the Editor).
Anon (1989) ‘Low cholesterol and increased risk’, Lancet 1, 1423–1425.
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Epstein, F.H. (1990). The effect of coronary heart disease prevention on the prevention of non-cardiovascular diseases. In: Descovich, G., Gaddi, A., Magri, G., Lenzi, S. (eds) Atherosclerosis and Cardiovascular Disease. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-0731-7_2
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DOI: https://doi.org/10.1007/978-94-009-0731-7_2
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