282 Ten-year risk of cancer mortality according to lipid levels and use of lipid-lowering drugs in the French general population

Abstract

Purpose The beneficial effect of lipid-lowering drugs on cardiovascular mortality is well established, but long term safety data remain scarce. The aim of this study was to assess 10-year risk of cancer mortality according to blood lipid levels and lipid-lowering drug exposure, in the French general population. Methods Our analysis was based on the Third French MONICA Cross-sectional survey on cardiovascular risk factors (1995-1996). Participants aged 35-64 years were randomly recruited from French polling lists. Subjects with a history of cancer at baseline were excluded from the analysis. Vital status and cause of mortality were obtained 10 years after inclusion. Results There were 3262 participants and 177 deaths were recorded (78 due to cancer). The sample was mainly composed of subjects in primary cardiovascular prevention (96%) and comprised 64% of normolipidemic, 25% of untreated dyslipidemic (total cholesterol ≥ 6.5 mmol/L or triglycerides ≥ 3.5 mmol/L) and 11% of dyslipidemic subjects treated with a lipid-lowering drug (4% statin, 6% fibrate). After adjustment for centre, age, smoking, gamma-glutamyl transpeptidase and mean corpuscular volume, which were all significantly associated with cancer mortality, the hazard ratio (HR) for cancer mortality in subjects with non HDL-cholesterol Conclusion In this cohort mainly composed of primary prevention subjects, low HDL- and low non HDL-cholesterol levels were associated with increased cancer mortality, whereas risk of cancer death was reduced in users of lipid-lowering drugs. This suggests that the impact of low cholesterol on cancer risk may be different in subjects with spontaneously low levels and in those for whom cholesterol is lowered by lipid-lowering drugs.