Cancer Causes & Control

, Volume 18, Issue 9, pp 1021–1029 | Cite as

Serum uric acid and risk of cancer mortality in a large prospective male cohort

  • Alexander M. Strasak
  • Kilian Rapp
  • Wolfgang Hilbe
  • Willi Oberaigner
  • Elfriede Ruttmann
  • Hans Concin
  • Günter Diem
  • Karl P. Pfeiffer
  • Hanno Ulmer
  • the VHM&PP Study Group
Original Paper



To examine the prognostic role of serum uric acid (SUA) for cancer mortality in apparently healthy men across a wide age range.


Prospective data from a large cohort of 83,683 male Austrian adults with a median follow-up of 13.6 years was analyzed. Cox proportional hazards models, adjusted for established risk factors, were calculated to evaluate SUA as a predictive marker for fatal cancer events.


High SUA (>6.71 mg/dl) was independently associated with increased risk of mortality from all cancers, showing a clear dose–response relationship (p for trend < 0.0001); the adjusted hazard ratio for the highest versus lowest quintile of SUA was 1.41 (1.22–1.62). In subgroup analyses this hazard ratio increased to 1.53 (1.29–1.80) for participants aged <65 years. When considering the time interval between baseline SUA measurement and subsequent death, SUA levels were more predictive for “late deaths”, occurring 10 or more years after screening (HR 1.65 [1.35–2.03], p < 0.0001), in comparison to deaths within 10 years after SUA measurement. In cancer site-specific analyses, SUA was significantly associated with deaths from malignant neoplasms of digestive organs (p = 0.03) and respiratory system and intrathoracic organs (p < 0.0001). Elevated SUA was further independently related to an increased risk of all-cause mortality (p < 0.0001).


Our results are contrary to the proposed antioxidant, inhibitory effect of SUA against cancer and rather suggest high SUA to be a valuable long-term surrogate parameter, indicative for a life-style at increased risk for the development of cancer.


Cancer mortality Serum uric acid Risk factor Epidemiology 



Members of the VHM&PP study group are Paul Gmeiner MD, Wolfgang Metzler MD, Elmar Stimpfl (Agency for Preventive- and Social Medicine, Bregenz, Austria), Jochen Klenk MSc, and Stephan K Weiland MD MSc† (Department of Epidemiology, University of Ulm, Germany). We would like to thank all the participants and physicians of the VHM&PP. We are grateful to the Government of the State of Vorarlberg, Austria for funding the program and thank Elmar Bechter MD and Hans-Peter Bischof MD at the Health Department of the Vorarlberg State Government.


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Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  • Alexander M. Strasak
    • 1
  • Kilian Rapp
    • 2
  • Wolfgang Hilbe
    • 3
  • Willi Oberaigner
    • 4
  • Elfriede Ruttmann
    • 5
  • Hans Concin
    • 6
  • Günter Diem
    • 6
  • Karl P. Pfeiffer
    • 1
  • Hanno Ulmer
    • 1
    • 6
  • the VHM&PP Study Group
  1. 1.Department of Medical Statistics, Informatics and Health EconomicsInnsbruck Medical UniversityInnsbruckAustria
  2. 2.Department of EpidemiologyUniversity of UlmUlmGermany
  3. 3.Department of Haematology and OncologyInnsbruck Medical UniversityInnsbruckAustria
  4. 4.Cancer Registry of TyrolDepartment of Clinical Epidemiology of the Tyrolean State Hospitals Ltd.InnsbruckAustria
  5. 5.Department of Cardiac SurgeryInnsbruck Medical UniversityInnsbruckAustria
  6. 6.Agency for Preventive and Social MedicineBregenzAustria

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