Association between plasma total cholesterol concentration and incident prostate cancer in the CLUE II cohort
Statin drugs appear to protect against advanced and possibly high-grade prostate cancer, perhaps through cholesterol-lowering. Thus, we evaluated the association between plasma cholesterol and prostate cancer. We conducted a prospective study in the CLUE II cohort of Washington County, MD. Included were 6,816 male county residents aged 35+ years old who did not have a cancer diagnosis at baseline in 1989. Plasma cholesterol, measured enzymatically at baseline, was categorized by clinical cutpoints. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for total (n = 438) and high-grade (Gleason sum ≥7, n = 137) prostate cancer. Compared to men with high cholesterol (≥240 mg/dl), men with desirable (<200 mg/dl) or borderline (200 to <240 mg/dl) levels were less likely to develop high-grade prostate cancer, particularly when restricting to organ-confined cases (HR: 0.68, 95% CI 0.40–1.18; P trend = 0.12) and among men with higher BMI (HR: 0.36, 95% CI 0.16–0.79; P trend = 0.02). Results were unchanged after excluding cholesterol-lowering drug users. Cholesterol was not associated with total prostate cancer. Our study supports two prior ones suggesting that cholesterol influences risk of high-grade prostate cancer, and indirectly supports the hypothesis that cholesterol-lowering is a mechanism by which statins are protective.
KeywordsCohort studies Prostatic neoplasms Cholesterol
Dr. Mondul was supported by a National Research Service Award (T32 CA009314) from the National Cancer Institute, National Institutes of Health. Funding for the CLUE II Cohort has been provided by grants from the National Cancer Institute (U01 CA086308) and the National Institute of Aging (U01 AG18033), National Institutes of Health. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.
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