Total serum cholesterol and cancer incidence in the Metabolic syndrome and Cancer Project (Me-Can).
OBJECTIVE
To investigate the association between total serum cholesterol (TSC) and cancer incidence in the Metabolic syndrome and Cancer project (Me-Can).


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria.
Susanne
S
Strohmaier
Michael
M
Edlinger
Jonas
J
Manjer
Tanja
T
Stocks
Tone
T
Bjørge
Wegene
W
Borena
Christel
C
Häggström
Anders
A
Engeland
Gabriele
G
Nagel
Martin
M
Almquist
Randi
R
Selmer
Steinar
S
Tretli
Hans
H
Concin
Göran
G
Hallmans
Håkan
H
Jonsson
Pär
P
Stattin
Hanno
H
Ulmer
D000328:Adult; D001317:Austria / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000145:classification / Q000150:complications / Q000175:diagnosis; D009664:Norway / Q000453:epidemiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking; D013548:Sweden / Q000453:epidemiology
D001786:Blood Glucose; D002784:Cholesterol