Cancer Causes & Control

, Volume 5, Issue 6, pp 501–509 | Cite as

Risk of breast cancer in relation to blood lipids: a prospective study of 31,209 Norwegian women

  • Maria Gaard
  • Steinar Tretli
  • Petter Urdal
Research Papers


In this prospective study, the relationship between blood lipids and breast cancer risk was examined. Between 1977 and 1983, 31,209 Norwegian women, 20 to 54 years of age, attended a health screening carried out by the Norwegian National Health Screening Services. The screening consisted of a questionnaire, anthropometric measurements, and nonfasting blood drawn for analysis of total serum cholesterol (TC), triglyceride (TG), and high density lipoprotein (HDL) cholesterol. Low density lipoprotein (LDL) cholesterol was calculated by the Friedewald's formula. During the seven to 13 years of follow-up, 302 breast cancer cases were identified by linkage to the Norwegian Cancer Registry. After adjustment for some of the known risk factors of breast cancer, the relative risk of women in the highest quartile of TC compared with women in the lowest quartile was 0.87 (95 percent confidence interval [CI]=0.61–1.23). The corresponding relative risks and CIs were 0.82 (CI=0.58–1.16) for TG, 1.02 (CI=0.73–1.42) for HDL, and 0.93 (CI=0.67–1.29) for LDL. No association between breast cancer risk and blood lipids was found in the total population, nor when the data were divided into those diagnosed before or after the age of 50 as a dividing line between pre- and postmenopausal diagnosis.

Key words

Breast cancer cholesterol HDL-cholesterol Norway serum lipids triglycerides 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Dunn JE Jr. Breast cancer among American Japanese in the San Francisco bay area.NCI Monogr 1975;47: 157–60.Google Scholar
  2. 2.
    Buell P. Changing incidence of breast cancer in Japanese American women.JNCI 1973;51: 1479–83.PubMedGoogle Scholar
  3. 3.
    Armstrong B, Doll R. Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices.Int J Cancer 1975;15: 617–31.PubMedGoogle Scholar
  4. 4.
    Drasar BS, Irving D. Environmental factors and cancer of the colon and breast.Br J Cancer 1973;27: 167–72.PubMedGoogle Scholar
  5. 5.
    Gaskill SP, Mcguire WL, Osborne CK, Stern MP. Breast cancer mortality and diet in the United States.Cancer Res 1979;39: 3628–37.Google Scholar
  6. 6.
    Fats and other lipids. In: Committee on Diet and Health, National Research Council.Diet and Health. Washington, DC: National Academy Press, 1989: 159–230.Google Scholar
  7. 7.
    International collaborative study group. Metabolic epidemiology of plasma cholesterol. Mechanisms of varition of plasma cholesterol within populations and between populations.Lancet 1986;ii: 991–5.Google Scholar
  8. 8.
    Keys A.Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease. Cambridge, MA (USA): Harvard University Press, 1980: 381.Google Scholar
  9. 9.
    Stallones RA. Ischemic heart disease and lipids in blood and diet.Ann Rev Nutr 1983;3: 155–85.Google Scholar
  10. 10.
    Stamler J. Population studies. In: Levy RI, Rifkind BM, Dennis BH, Ernst N, eds.Nutrition, Lipids and Coronary Heart Disease: A Global View. Nutrition in Health and Disease, Vol 1. New York, NY (USA): Raven Press, 1979: 25–88.Google Scholar
  11. 11.
    Shekelle RB, Stamler J, Paul O, Shyrock AM, Liu S, Lepper M. Dietary lipids and serum cholesterol level: change in diet confounds the cross-sectional association.Am J Epidemiol 1981;115: 506–14.Google Scholar
  12. 12.
    Gordon DJ, Salz KM, Roggenkamp KJ, Franklin FA. Dietary determinants of plasma cholesterol change in the recruitment phase of the Lipid Reseach Clinics Coronary Primary Prevention Trial.Arteriosclerosis 1982;2: 537–48.PubMedGoogle Scholar
  13. 13.
    Mensink RP, Katan MB. Effect of dietary fatty acids on serum lipids and lipoproteins. A meta-analysis of 27 trials.Arterioscler Thromb 1992;12: 911–9.PubMedGoogle Scholar
  14. 14.
    Boyd NF, McGuire V. Evidence of association between plasma high-density lipoprotein cholesterol and risk factors for breast cancer.JNCI 1990;82: 460–8.PubMedGoogle Scholar
  15. 15.
    Törnberg SA, Holm L-E, Carstensen JM. Breast cancer risk in relation to serum cholesterol, serum beta-lipoprotein, height, weight, and blood pressure.Acta Oncol 1988;27: 31–7.PubMedGoogle Scholar
  16. 16.
    Hiatt RA, Friedman GD, Bawol RD, Ury HK. Breast cancer and serum cholesterol.JNCI 1982;68: 885–9.PubMedGoogle Scholar
  17. 17.
    Vatten L, Foss OP. Total serum cholesterol and triglycerides and risk of breast cancer: A prospective study of 24,329 Norwegian women.Cancer Res 1990;50: 2341–6.PubMedGoogle Scholar
  18. 18.
    Höyer AP, Engholm G. Serum lipids and breast cancer risk: a cohort study of 5,207 Danish women.Cancer Causes Control 1992;3: 403–8.PubMedGoogle Scholar
  19. 19.
    Bjartveit K, Foss OP, Gjervig T, Lund-Larsen PG. The cardiovascular disease study in Norwegian counties. Background and organisation.Acta Med Scand 1979;Suppl 634: 1–70.Google Scholar
  20. 20.
    Westlund K. The cardiovascular disease study in Norwegian counties. Results from the second screening. Oslo, Norway: Monograph from the National Health Screening Services, 1988.Google Scholar
  21. 21.
    Röschlau P, Bernt E, Gruber W. Enzymatische bestimmung des Gesamt-cholesterin in Serum.Z Klin Chem Biochem 1974;12: 403–7.Google Scholar
  22. 22.
    Eggstein M, Kreutz FH. Eine neue Bestimmung der Neutralfette im Blutserum und Gewebe.Klin Wochenschr 1966;44: 262–7.PubMedGoogle Scholar
  23. 23.
    Lipid Research Clinics Program.Manual of Laboratory Operations, Vol 1. Lipid and Lipoprotein Analysis. Bethesda, MD (USA): National Institutes of Health, 1974; DHEW Pub. No. (NIH) 75-628.Google Scholar
  24. 24.
    Burstein M, Scholnik HR, Morfin R. Rapid method for the isolation of lipoproteins from human serum by precipitation with polyanions.J Lipid Res 1970;11: 583–5.PubMedGoogle Scholar
  25. 25.
    Thelle DS, Førde OH, Arnesen E. Distribution of high-density lipoprotein cholesterol according to age, sex, and ethnic origin: cardiovascular disease study in Finnmark 1977.J Epidemiol Comm Health 1982;36: 243–7.Google Scholar
  26. 26.
    Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.Clin Chem 1972;18: 499–502.PubMedGoogle Scholar
  27. 27.
    Lund E.Pilot Study for the Evaluation of Completeness of Reporting to the Cancer Registry. Incidence of Cancer in Norway, 1978. Oslo, Norway: The Cancer Registry of Norway, 1981: 11–5.Google Scholar
  28. 28.
    Applied regression analysis and other multivariate methods. In: Kleinbaum DG, Kupper LL, Muller KE, eds.Poisson Regression Analysis. Boston, MA (USA): PWS-Kent, 1988: 497–512.Google Scholar
  29. 29.
    Preston DL, Lubin JH, Pierce DA, EPICURE.User's Guide. Seattle, WA (USA): Hirosoft International Corporation, 1988–93.Google Scholar
  30. 30.
    Prentice RL, Pepe M, Self SG. Dietary fat and breast cancer: a quantative assessment of the epidemiological literature and a discussion of methodological issues.Cancer Res 1989;49: 3147–56.PubMedGoogle Scholar
  31. 31.
    Willett W. The search for the causes of breast and colon cancer.Nature 1989;338: 389–94.PubMedGoogle Scholar
  32. 32.
    van den Brandt PA, van't Veer P, Goldbohm A, et al. A prospective cohort study on dietary fat and the risk of postmenopausal breast cancer.Cancer Res 1993;53: 75–82.PubMedGoogle Scholar
  33. 33.
    Mjøs OD, Rao SN, Henden T, Thelle DS, Forde OH, Miller NE. A longitudinal study of the biological variability of plasma lipoproteins in healthy young adults.Atherosclerosis 1979;34: 75–81.PubMedGoogle Scholar
  34. 34.
    Homb T, Eeg-Larsen N, Norum K, Skjervold H, Øgrim ME, Opsahl B. Animal fat in Norwegian diet (in Norwegian). Norges landbruksvitenskapelige forskningsråd's utredning nr. 103, 1979.Google Scholar
  35. 35.
    Arntzenius AC, Kromhout D, Barth JD, et al.. Diet, lipoproteins, and the progression of coronary heart disease.N Engl J Med 1985;312: 805–11.PubMedGoogle Scholar
  36. 36.
    National Diet Heart Study Research Group. The national diet heart study final report. Serum cholesterol response.Am Heart Assoc Monogr 1968;18: 181–223.Google Scholar
  37. 37.
    Hunter D. Biochemical indicators of dietary intake. In: Willett W.Nutritional Epidemiology. Oxford, UK: Oxford University Press, 1990: 143–216.Google Scholar
  38. 38.
    Kim H-J, Kalkhoff RK. Changes in lipoprotein composition during the menstrual cycle.Metabolism 1979;28: 663–8.PubMedGoogle Scholar
  39. 39.
    Mattsson LÅ, Silfverstolpe G, Samsioe G. Lipid composition of serum lipoproteins in relation to gonadal hormones during the normal menstrual cycle.Eur J Obstet Gynec Reprod Biol 1984;17: 327–35.Google Scholar
  40. 40.
    Kissebh AH, Schectman G. Hormones and lipoprotein metabolism. In:Baillier's Clinical Endocrinology and Metabolism. Vol 1, No. 3. London, UK 1987;1: 699–726.Google Scholar
  41. 41.
    Heller DA, de-Faire U, Pedersen NL, Dahlen G, McClearn-GE. Genetic and environmental influences on serum lipid levels in twins.N Eng J Med 1993;328: 1150–6.Google Scholar
  42. 42.
    Bani IA, Williams CM, Boulter PS, Dickerson JWT. Plasma lipids and prolactin in patients with breast cancer.Br J Cancer 1986;54: 439–46.PubMedGoogle Scholar
  43. 43.
    Kumar K, Sachdanandam P, Arivazhagan R. Studies on the changes in plasma lipids and lipoproteins in patients with benign and malignant breast cancer.Biochem Int 1991;23: 581–9.PubMedGoogle Scholar
  44. 44.
    Gerber M, Cavallo F, Marubini E, et al. Liposoluble vitamins and lipid parameters in breast cancer. A joint study in northern Italy and southern France.Int J Cancer 1988;42: 489–94.PubMedGoogle Scholar
  45. 45.
    Basu TK, Williams DC. Plasma and body lipids in patients with carcinoma of the breast.Oncology 1975;31: 172–6.PubMedGoogle Scholar
  46. 46.
    Smethurst M, Basu TK, Williams DC. Level of cholesterol, 11-hydrocorticosteroids and progesteron in plasma from post-menopausal women with breast cancer.Europ J Cancer 1975;11: 751–5.Google Scholar
  47. 47.
    Alexopoulos CG, Blatsios B, Avgerinos A. Serum lipids and lipoprotein disorders in cancer patients.Cancer 1987;60: 3065–70.PubMedGoogle Scholar
  48. 48.
    Potischman N, McCulloch CE, Byers T, et al. Associations between breast cancer, plasma triglycerides, and cholesterol.Nutr Cancer 1991;15: 205–15.PubMedGoogle Scholar
  49. 49.
    Zielinski CC, Stuller I, Rausch P, Muller C. Increased serum concentrations of cholesterol and triglycerides in the progression of breast cancer.J Cancer Res Clin Oncol 1988;114: 514–8.PubMedGoogle Scholar

Copyright information

© Rapid Communications of Oxford Ltd 1994

Authors and Affiliations

  • Maria Gaard
    • 1
  • Steinar Tretli
    • 1
  • Petter Urdal
    • 2
  1. 1.Institute for Epidemiological Cancer ResearchCancer Registry of NorwayOsloNorway
  2. 2.Department of Clinical ChemistryUlleval HospitalOsloNorway

Personalised recommendations