Journal Article

Total Serum Cholesterol and Cancer Incidence in the Metabolic Syndrome and Cancer Project (Me-Can)

Stocks, Tanja, Selmer, Randi, Concin, Hans, Jonsson, Håkan, Manjer, Jonas, Bjørge, Tone, Borena, Wegene, Edlinger, Michael, Hallmans, Göran, Ulmer, Hanno, Häggström, Christel, Nagel, Gabriele, Tretli, Steinar, Stattin, Pär, Engeland, Anders, Almquist, Martin, Strohmaier, Susanne

2013

Overview

To investigate the association between total serum cholesterol (TSC) and cancer incidence in the Metabolic syndrome and Cancer project (Me-Can). Me-Can consists of seven cohorts from Norway, Austria, and Sweden including 289,273 male and 288,057 female participants prospectively followed up for cancer incidence (n = 38,978) with a mean follow-up of 11.7 years. Cox regression models with age as the underlying time metric were used to estimate hazard ratios (HR) and their 95% confidence intervals (CI) for quintiles of cholesterol levels and per 1 mmol/l, adjusting for age at first measurement, body mass index (BMI), and smoking status. Estimates were corrected for regression dilution bias. Furthermore, we performed lag time analyses, excluding different times of follow-up, in order to check for reverse causation. In men, compared with the 1st quintile, TSC concentrations in the 5th quintile were borderline significantly associated with decreasing risk of total cancer (HR = 0.94; 95%CI: 0.88, 1.00). Significant inverse associations were observed for cancers of the liver/intrahepatic bile duct (HR = 0.14; 95%CI: 0.07, 0.29), pancreas cancer (HR = 0.52, 95% CI: 0.33, 0.81), non-melanoma of skin (HR = 0.67; 95%CI: 0.46, 0.95), and cancers of the lymph-/hematopoietic tissue (HR = 0.68, 95%CI: 0.54, 0.87). In women, hazard ratios for the 5th quintile were associated with decreasing risk of total cancer (HR = 0.86, 95%CI: 0.79, 0.93) and for cancers of the gallbladder (HR = 0.23, 95%CI: 0.08, 0.62), breast (HR = 0.70, 95%CI: 0.61, 0.81), melanoma of skin (HR = 0.61, 95%CI: 0.42, 0.88), and cancers of the lymph-/hematopoietic tissue (HR = 0.61, 95%CI: 0.44, 0.83). TSC was negatively associated with risk of cancer overall in females and risk of cancer at several sites in both males and females. In lag time analyses some associations persisted, suggesting that for these cancer sites reverse causation did not apply.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Austria - epidemiology / Bile ducts / Biology / Biomarkers / Blood Glucose - analysis / Body mass / Body Mass Index / Body size / Breast cancer / Cancer / Cardiovascular disease / Causation / Cholesterol / Cholesterol - blood / Clinical Medicine / Colorectal cancer / Confidence intervals / Dilution / Disease prevention / Epidemiology / Fasting / Female / Females / Gallbladder / Gallbladder cancer / Health care / Health economics / Health risk assessment / Health risks / Hospitals / Humans / Hypotheses / Incidence / Kirurgi / Klinisk medicin / Lag time / Liver / Liver cancer / Longitudinal Studies / Lymph / Male / Males / Medical and Health Sciences / Medical research / Medical statistics / Medicin och hälsovetenskap / Medicine / Melanoma / Metabolic disorders / Metabolic syndrome / Metabolic Syndrome - blood / Metabolic Syndrome - complications / Metabolic Syndrome - diagnosis / Middle Aged / Mortality / Neoplasms - blood / Neoplasms - classification / Neoplasms - complications / Neoplasms - diagnosis / Norway - epidemiology / Pancreas / Pancreatic cancer / Population / Preventive medicine / Primary care / Proportional Hazards Models / Public health / Regression analysis / Regression models / Risk / Risk Factors / Risk reduction / Skin / Smoking / Statistical analysis / Studies / Surgery / Sweden - epidemiology / Urology / Womens health