title: Racial Differences in the Association Between Preoperative Serum Cholesterol and Prostate Cancer Recurrence: Results from the SEARCH Database.
abstract: BACKGROUND
  Black men are disproportionately affected by both cardiovascular disease and prostate cancer. Epidemiologic evidence linking dyslipidemia, an established cardiovascular risk factor, and prostate cancer progression is mixed. As existing studies were conducted in predominantly non-black populations, research on black men is lacking.
  
  
  METHODS
  We identified 628 black and 1,020 non-black men who underwent radical prostatectomy and never used statins before surgery in the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Median follow-up was 2.9 years. The impact of preoperative hypercholesterolemia on risk of biochemical recurrence was examined using multivariable, race-stratified proportional hazards. In secondary analysis, we examined associations with low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides, overall and among men with dyslipidemia.
  
  
  RESULTS
  High cholesterol was associated with increased risk of recurrence in black [HR(per10 mg/dL) 1.06; 95% confidence interval (CI), 1.02-1.11] but not non-black men (HR(per10 mg/dL) 0.99; 95% CI, 0.95-1.03; P(interaction) = 0.011). Elevated triglycerides were associated with increased risk in both black and non-black men (HR(per10 mg/dL) 1.02; 95% CI, 1.00-1.03 and 1.02; 95% CI, 1.00-1.02, respectively; P(interaction) = 0.458). There were no significant associations between LDL or HDL and recurrence risk in either race. Associations with cholesterol, LDL, and triglycerides were similar among men with dyslipidemia, but low HDL was associated with increased risk of recurrence in black, but not non-black men with dyslipidemia (P(interaction) = 0.047).
  
  
  CONCLUSIONS
  Elevated cholesterol was a risk factor for recurrence in black but not non-black men, whereas high triglycerides were associated with increased risk regardless of race.
  
  
  CONCLUSIONS
  Significantly contrasting associations by race may provide insight into prostate cancer racial disparities.
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Emma H
authors.initials: EH
authors.lastname: Allott
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Howard
authors.affiliation: Urology Section, Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California. Department of Urology, UCLA School of Medicine, Los Angeles, California.
authors.forename: William J
authors.initials: WJ
authors.lastname: Aronson
authors.affiliation: Section of Urology, Veterans Affairs Medical Center, Augusta, Georgia. Section of Urology, Medical College of Georgia, Augusta, Georgia.
authors.forename: Martha K
authors.initials: MK
authors.lastname: Terris
authors.affiliation: Urology Department, University of California San Diego Health System, San Diego, California.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Kane
authors.affiliation: Division of Urology, Oregon Health & Sciences University, Portland, Oregon.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Amling
authors.affiliation: Department of Urology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Cooperberg
authors.affiliation: Cedars Sinai Medical Center, Los Angeles, California. Division of Urology, Veterans Affairs Medical Center, Durham, North Carolina. stephen.freedland@cshs.org.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Freedland
mesh_terms: D044383:Black People; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D050171:Dyslipidemias / Q000097:blood / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000208:ethnology*; D011471:Prostatic Neoplasms / Q000097:blood / Q000208:ethnology*; D012189:Retrospective Studies
chemical_list: D002784:Cholesterol
references.citation: PLoS One. 2012;7(1):e30062
references.pmid: 22279565
references.citation: J Natl Cancer Inst. 2011 Jun 8;103(11):885-92
references.pmid: 21498780
references.citation: Cancer Epidemiol Biomarkers Prev. 2015 Jul;24(7):1086-93
references.pmid: 25953767
references.citation: JAMA. 2005 Jul 27;294(4):433-9
references.pmid: 16046649
references.citation: Asian Pac J Cancer Prev. 2007 Apr-Jun;8(2):199-205
references.pmid: 17696731
references.citation: Cancer Epidemiol Biomarkers Prev. 2009 Nov;18(11):2814-21
references.pmid: 19887581
references.citation: Obesity (Silver Spring). 2008 Mar;16(3):600-7
references.pmid: 18239557
references.citation: Biochim Biophys Acta. 2014 Sep;1843(9):1839-50
references.pmid: 24769209
references.citation: Eur Urol. 2013 May;63(5):800-9
references.pmid: 23219374
references.citation: Cancer Causes Control. 2012 Aug;23(8):1289-96
references.pmid: 22692409
references.citation: Circulation. 2002 Dec 17;106(25):3143-421
references.pmid: 12485966
references.citation: Cancer Epidemiol Biomarkers Prev. 2014 Nov;23(11):2349-56
references.pmid: 25304929
references.citation: Circulation. 2005 Mar 15;111(10):1233-41
references.pmid: 15769763
references.citation: PLoS One. 2013;8(7):e65174
references.pmid: 23935815
references.citation: Prostate Cancer. 2011;2011:245642
references.pmid: 22096652
references.citation: J Natl Cancer Inst. 2006 Dec 20;98(24):1819-25
references.pmid: 17179483
references.citation: Int J Gen Med. 2014 Aug 07;7:393-400
references.pmid: 25143752
references.citation: Am J Epidemiol. 1998 Oct 15;148(8):750-60
references.pmid: 9786230
references.citation: Cancer Res. 2002 Apr 15;62(8):2227-31
references.pmid: 11956073
references.citation: Metab Syndr Relat Disord. 2011 Feb;9(1):35-40
references.pmid: 20958206
references.citation: CA Cancer J Clin. 2015 Jan-Feb;65(1):5-29
references.pmid: 25559415
references.citation: Epidemiology. 2014 Nov;25(6):823-8
references.pmid: 25207955
references.citation: Prostate. 2011 Jun 15;71(9):985-97
references.pmid: 21541975
references.citation: BMC Cancer. 2012;12:25
references.pmid: 22260413
references.citation: J Urol. 2009 Nov;182(5):2219-25
references.pmid: 19758611
references.citation: Cancer Causes Control. 2011 Feb;22(2):311-8
references.pmid: 21116843
references.citation: J Clin Epidemiol. 1988;41(6):519-30
references.pmid: 3290396
references.citation: Eur J Epidemiol. 2014 Feb;29(2):119-32
references.pmid: 24519551
references.citation: Cancer. 2013 Jun 15;119(12):2282-90
references.pmid: 23575751
references.citation: Cancer Epidemiol Biomarkers Prev. 2014 Nov;23(11):2404-12
references.pmid: 25146088
references.citation: Urology. 2009 Jul;74(1):185-90
references.pmid: 19428088
references.citation: J Clin Oncol. 2010 Jun 1;28(16):2653-9
references.pmid: 20421534