Cholesterol and prostate cancer risk: a long-term prospective cohort study.

Trond Heir,Leiv Sandvik,Ragnhild Sørum Falk,Trude Eid Robsahm,Steinar Tretli,Jan Erikssen

doi:10.1186/s12885-016-2691-5

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https://doi.org/10.1186/s12885-016-2691-5

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Journal: BMC cancer	Publication Date: Aug 17, 2016
Citations: 30	License type: cc-by

Affiliation: Oslo University Hospital, Cancer Registry of Norway

Abstract

BackgroundFew studies have taken risk of competing events into account when examining the relationship between cholesterol and prostate cancer incidence, and few studies have a follow-up over several decades. We aimed to use these approaches to examine the relationship between cholesterol and prostate cancer.MethodsA cohort of 1997 healthy Norwegian men aged 40–59 years in 1972–75 was followed throughout 2012. Cancer data were extracted from the Cancer Registry of Norway. The association between cholesterol and prostate cancer incidence was assessed using competing risk regression analysis, with adjustment for potential confounders. Date and cause of death was obtained from the Cause of Death Registry of Norway.ResultsThe study cohort had a cancer risk similar to the general Norwegian population. Prostate cancer was registered in 213 men (11 %), including 62 (3 %) with advanced stage at diagnosis. For overall and advanced stage prostate cancer, the incidence was twice as high in the lowest quartile of cholesterol compared to the highest quartile. These associations remained significant after adjustment for age, smoking, physical fitness, BMI, and systolic blood pressure. Furthermore, high physical fitness and low BMI were associated with increased prostate cancer incidence. Sensitivity analyses excluding events during the first 20 years of observation revealed similar results.ConclusionLow cholesterol, as well as high physical fitness and low BMI, may be associated with increased risk of prostate cancer. These findings conflict with current prostate cancer prevention recommendations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2691-5) contains supplementary material, which is available to authorized users.

Highlights

Few studies have taken risk of competing events into account when examining the relationship between cholesterol and prostate cancer incidence, and few studies have a follow-up over several decades
Based on a cohort of initially healthy middle-aged men followed for 40 years [24,25,26], we aimed to examine the relationship between total cholesterol and the incidence of overall and advanced stage prostate cancer, focusing on the challenges mentioned above
Cox regression to evaluate the effect of selected covariates on prostate cancer incidence ignoring death as competing event, n = 1997

Summary

Introduction

Few studies have taken risk of competing events into account when examining the relationship between cholesterol and prostate cancer incidence, and few studies have a follow-up over several decades. We aimed to use these approaches to examine the relationship between cholesterol and prostate cancer. The role of cholesterol and prostate cancer has been a topic of research for many years. Several observational studies in the 1980s aroused suspicion of an association between low cholesterol and increased prostate cancer risk [1,2,3]. From a cell biological point of view, cholesterol may play an important role in prostate cancer cell growth [17]. A review of a series of reports suggests that use of statins in cholesterol-lowering therapies may reduce the risk of aggressive prostate cancer [18]. A possible implication is that cholesterol-lowering therapies may provide an opportunity to alter the disease course [19]

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