Time-dependent association of total serum cholesterol and cancer incidence in a cohort of 172,210 men and women: a prospective 19-year follow-up study.
BACKGROUND
The relationship between serum cholesterol and cancer incidence remains controversial.


METHODS
We investigated the association of total serum cholesterol (TSC) with subsequent cancer incidence in a population-based cohort of 172 210 Austrian adults prospectively followed up for a median of 13.0 years. Cox regression, allowing for time-dependent effects, was used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) for the association of TSC with cancer.


RESULTS
We observed pronounced short-term associations of TSC and overall cancer incidence in both men and women. For malignancies diagnosed shortly (<5 months) after baseline TSC measurement, the highest TSC tertile (>235.0 mg/dl in men and >229.0 in women) compared with the lowest tertile (<194.0 mg/dl in men and <190.0 in women) was associated with a significantly lower overall cancer risk [HR = 0.58 (95% CI 0.43-0.78, P(trend) = 0.0001) in men, HR = 0.69 (95% CI 0.49-0.99, P(trend) = 0.03) in women]. However, after roughly 5 months from baseline measurement, overall cancer risk was not significantly associated with TSC. The short-term inverse association of TSC with cancer was mainly driven by malignancies of the digestive organs and lymphoid and hematopoietic tissue.


CONCLUSIONS
The short-term decrease of cancer risk seen for high levels of TSC may largely capture preclinical effects of cancer on TSC.
Strasak
A M
AM
Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria. alexander.strasak@i-med.ac.at
Pfeiffer
R M
RM
Brant
L J
LJ
Rapp
K
K
Hilbe
W
W
Oberaigner
W
W
Lang
S
S
Borena
W
W
Concin
H
H
Diem
G
G
Ruttmann
E
E
Glodny
B
B
Pfeiffer
K P
KP
Ulmer
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002784:Cholesterol / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000453:epidemiology*; D011446:Prospective Studies; D055815:Young Adult
D002784:Cholesterol